Doctor Name: | DONALD HORNE |
NPI Number: | 1508296922 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | NURSE PRACTITIONER |
License Number: | R877928 |
Business Practice Address: | 3794 Hwy 468 Pearl, MS - 39208 |
Business Phone Number: | 6019322880 |
Business Fax Number: | |
Mailing Address: | 921 Prince Dr, BRANDON |
State: | MS |
Postal Code: | 390428361 |
Phone Number: | 6019393305 |
Fax Number: | |
NPI Enumeration Date: | 11/21/2013 |
NPI Last Update Date: | 11/21/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R877928 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |