Healthcare Provider Details

I. General information

NPI: 1427968486
Provider Name (Legal Business Name): KIMBERLEY HORTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 ROBERSON ST. 204 ROBERSON ST.
ROGERSVILLE MO
65742
US

IV. Provider business mailing address

204 ROBERSON ST. 204 ROBERSON ST.
ROGERSVILLE MO
65742
US

V. Phone/Fax

Practice location:
  • Phone: 417-224-1885
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2018005903
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: