Healthcare Provider Details

I. General information

NPI: 1407449101
Provider Name (Legal Business Name): REBECCA FRASHER HORTON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2021
Last Update Date: 02/15/2021
Certification Date: 02/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 NEWSOME RD
KING NC
27021-8507
US

IV. Provider business mailing address

1530 TWIN OAKS DR
KING NC
27021-9792
US

V. Phone/Fax

Practice location:
  • Phone: 336-983-0941
  • Fax: 336-983-0958
Mailing address:
  • Phone: 336-596-7220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number174089
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: