Provider Demographics
NPI:1659119352
Name:MASON, JOSHUA GAIGE (APRN FNP-C)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:GAIGE
Last Name:MASON
Suffix:
Gender:M
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 E OAK LN
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75961-4707
Mailing Address - Country:US
Mailing Address - Phone:936-652-5059
Mailing Address - Fax:
Practice Address - Street 1:1615 W CHURCH ST STE 100
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-8862
Practice Address - Country:US
Practice Address - Phone:888-634-3627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1168987363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily