Healthcare Provider Details

I. General information

NPI: 1861225591
Provider Name (Legal Business Name): JOLYNN HORNER APRN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2024
Last Update Date: 02/17/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 MERCY RD
OMAHA NE
68124-2319
US

IV. Provider business mailing address

7500 MERCY RD
OMAHA NE
68124-2319
US

V. Phone/Fax

Practice location:
  • Phone: 855-524-4001
  • Fax: 402-398-5589
Mailing address:
  • Phone: 855-524-4001
  • Fax: 402-398-5589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number115560
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: