Provider Demographics
NPI:1053877951
Name:MCGAFFIC, JOSHUA STEVEN (MSN, RN, FNP-BC)
Entity type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:STEVEN
Last Name:MCGAFFIC
Suffix:
Gender:M
Credentials:MSN, RN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 VILLA ROSA DR
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-8070
Mailing Address - Country:US
Mailing Address - Phone:330-831-5674
Mailing Address - Fax:
Practice Address - Street 1:5760 PATRIOT BLVD # C
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-1170
Practice Address - Country:US
Practice Address - Phone:330-270-8610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-15
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH418129363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0336665Medicaid