Doctor Name: | KELLY DUTTON HORNE |
NPI Number: | 1154730554 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 5007086 |
Business Practice Address: | 2301 Us Highway 74 West Wadesboro, NC - 28170 |
Business Phone Number: | 7049944900 |
Business Fax Number: | |
Mailing Address: | 258 Baker Rd, WADESBORO |
State: | NC |
Postal Code: | 28170 |
Phone Number: | 7046948078 |
Fax Number: | |
NPI Enumeration Date: | 08/11/2014 |
NPI Last Update Date: | 08/11/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 5007086 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |