Healthcare Provider Details

I. General information

NPI: 1821924754
Provider Name (Legal Business Name): MICHELLE VAN HORN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7484 WILSON RD
WARRENTON VA
20186-7457
US

IV. Provider business mailing address

2265 KRAFT DR
BLACKSBURG VA
24060-6360
US

V. Phone/Fax

Practice location:
  • Phone: 703-638-4967
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: