Healthcare Provider Details

I. General information

NPI: 1124452370
Provider Name (Legal Business Name): CHRISTOPHER T HORNER MSN, FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2013
Last Update Date: 04/20/2021
Certification Date: 03/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 MCKINLEY STREET
BOLIVAR PA
15923-0038
US

IV. Provider business mailing address

640 KOLTER DR
INDIANA PA
15701-3570
US

V. Phone/Fax

Practice location:
  • Phone: 724-676-4709
  • Fax: 724-676-4752
Mailing address:
  • Phone: 724-357-7196
  • Fax: 724-357-7279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN603096
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: