Provider Demographics
NPI:1184080640
Name:MINGA, JOSHUA (NP-C)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:MINGA
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ECRU
Mailing Address - State:MS
Mailing Address - Zip Code:38841-9604
Mailing Address - Country:US
Mailing Address - Phone:662-489-4345
Mailing Address - Fax:662-489-8975
Practice Address - Street 1:100 BAPTIST MEMORIAL CIR STE 202
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-4476
Practice Address - Country:US
Practice Address - Phone:662-227-3255
Practice Address - Fax:662-636-2451
Is Sole Proprietor?:No
Enumeration Date:2016-01-13
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS901386363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily