Healthcare Provider Details

I. General information

NPI: 1124082094
Provider Name (Legal Business Name): PATRICIA MARIE HORN TOWERS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PATRICIA MARIE HORN ARNP

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 05/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8725 N WICKHAM RD SUITE 302
MELBOURNE FL
32940-5997
US

IV. Provider business mailing address

PO BOX 561600
ROCKLEDGE FL
32956-1600
US

V. Phone/Fax

Practice location:
  • Phone: 321-434-9230
  • Fax: 321-434-9231
Mailing address:
  • Phone: 321-434-4600
  • Fax: 321-259-0635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP1253602
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: