Healthcare Provider Details

I. General information

NPI: 1043650054
Provider Name (Legal Business Name): ROBIN RAE HORTON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2013
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

568 S MAIN ST
MONROE UT
84754-4400
US

IV. Provider business mailing address

1055 N 500 W
PROVO UT
84604-3305
US

V. Phone/Fax

Practice location:
  • Phone: 435-527-8866
  • Fax: 435-527-4436
Mailing address:
  • Phone: 801-354-8225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number191349-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: