Healthcare Provider Details

I. General information

NPI: 1205388634
Provider Name (Legal Business Name): LAURIE L HORVATH CERTIFIED NURSE MIDW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2016
Last Update Date: 09/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1651 E MARKET
WARREN OH
44483
US

IV. Provider business mailing address

1651 E MARKET
WARREN OH
44483
US

V. Phone/Fax

Practice location:
  • Phone: 330-394-4900
  • Fax: 330-394-5900
Mailing address:
  • Phone: 330-394-4900
  • Fax: 330-394-5900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberCNM3616
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPRN.CNM.019300
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: