Most Relevant Information
Provider Data
| NPI Number: | 1003446006 |
| Provider Name: | JOSHUA BOOTH CRNA |
| Entity Type: | Individual |
| Taxonomy Code: | 367500000X |
| Specialty: | Nurse Anesthetist, Certified Registered |
| License Number: | 4704276659 |
Most Important Dates
| Enumeration Date: | 01/19/2020 |
| Last Updated: | 01/19/2020 |
Provider Practice Location
205 N EAST AVE
JACKSON
MI
492011753
Practice Location Phone/Fax
| Phone: | 5172054800 |
| Fax: |
Provider Mailing Location
16206 WETHERBY ST
BEVERLY HILLS
MI
480255559
Provider Mailing Phone/Fax
| Phone: | 2485502279 |
| Fax: |