Provider Demographics
NPI:1427797778
Name:LAFLEUR, JOSH
Entity type:Individual
Prefix:
First Name:JOSH
Middle Name:
Last Name:LAFLEUR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7322 HARVEY HENRY RD
Mailing Address - Street 2:
Mailing Address - City:CORRYTON
Mailing Address - State:TN
Mailing Address - Zip Code:37721-2502
Mailing Address - Country:US
Mailing Address - Phone:865-385-2286
Mailing Address - Fax:
Practice Address - Street 1:7322 HARVEY HENRY RD
Practice Address - Street 2:
Practice Address - City:CORRYTON
Practice Address - State:TN
Practice Address - Zip Code:37721-2502
Practice Address - Country:US
Practice Address - Phone:865-385-2286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12822406164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse