Healthcare Provider Details

I. General information

NPI: 1710407119
Provider Name (Legal Business Name): CASSANDRA ANN HORTON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2017
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 N MAIN ST
GARDEN CITY KS
67846-5561
US

IV. Provider business mailing address

9100 E MINERAL CIR
CENTENNIAL CO
80112-3401
US

V. Phone/Fax

Practice location:
  • Phone: 620-276-8201
  • Fax: 620-276-8739
Mailing address:
  • Phone: 303-673-7206
  • Fax: 303-649-6954

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-77675-102
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: