Doctor Name: | KEVIN HORN |
NPI Number: | 1205808128 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | ARNP |
License Number: | ARNP9224044 |
Business Practice Address: | 311 Nw 250th St Newberry, FL - 326694454 |
Business Phone Number: | 3524726776 |
Business Fax Number: | 3524726778 |
Mailing Address: | 789 W Duval St, LAKE CITY |
State: | FL |
Postal Code: | 320553811 |
Phone Number: | 3867555044 |
Fax Number: | 3867552518 |
NPI Enumeration Date: | 02/03/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | ARNP9224044 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |