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General NPI Number Information
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NPI Number | 1205808128
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Entity Type | Individual
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Provider Name | KEVIN HORN ARNP
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Gender | Male
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Dates
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Enumeration Date | 02/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 311 NW 250TH ST
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City | NEWBERRY
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State | FL
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Zip | 32669-4454
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Country | US
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Telephone | 352-472-6776
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Fax | 352-472-6778
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Provider Business Mailing Address
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Address Line | 789 W DUVAL ST
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City | LAKE CITY
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State | FL
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Zip | 32055-3811
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Country | US
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Telephone | 386-755-5044
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Fax | 386-755-2518
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | ARNP9224044
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License Number State | FL
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