Provider Demographics
NPI:1053759456
Name:AUGUSTIN, JOSEPH DAVID (FNP)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:DAVID
Last Name:AUGUSTIN
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:JOE
Other - Middle Name:
Other - Last Name:AUGUSTIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:1735 27TH STREET
Mailing Address - Street 2:WALLER BLDG SUITE B06
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662
Mailing Address - Country:US
Mailing Address - Phone:740-356-8034
Mailing Address - Fax:740-353-7900
Practice Address - Street 1:1248 KINNEYS LN
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-2927
Practice Address - Country:US
Practice Address - Phone:740-356-7290
Practice Address - Fax:740-356-7938
Is Sole Proprietor?:No
Enumeration Date:2013-06-06
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.14516363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner