Provider Demographics
NPI:1255124392
Name:VIRDEN, JOSHUA HABAKKUK
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:HABAKKUK
Last Name:VIRDEN
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 1:700 HANCOCK AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44314-1040
Mailing Address - Country:US
Mailing Address - Phone:234-706-0123
Mailing Address - Fax:
Practice Address - Street 1:700 HANCOCK AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44314-1040
Practice Address - Country:US
Practice Address - Phone:234-706-0123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
376J00000X
OH376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker