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General NPI Number Information
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NPI Number | 1093894644
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Entity Type | Individual
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Provider Name | VIRGINIA G VAN HORN CRNA
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Gender | Female
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 09/26/2022
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Provider Practice Location Address
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Address Line | 12850 TOEPPERWEIN RD
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City | LIVE OAK
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State | TX
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Zip | 78233-4115
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Country | US
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Telephone | 210-614-1234
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Fax |
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Provider Business Mailing Address
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Address Line | 1731 OAK GLN
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City | NEW BRAUNFELS
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State | TX
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Zip | 78132-3839
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Country | US
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Telephone | 203-509-2094
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AP118134
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License Number State | TX
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