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General NPI Number Information
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NPI Number | 1497643779
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Entity Type | Individual
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Provider Name | KEVIN DOUGLAS HORN NP
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Gender | Male
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Dates
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Enumeration Date | 06/25/2025
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 912 W 21ST ST
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City | CLOVIS
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State | NM
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Zip | 88101-4149
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Country | US
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Telephone | 575-904-7577
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Fax | 505-369-3406
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Provider Business Mailing Address
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Address Line | 2006 53RD ST
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City | LUBBOCK
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State | TX
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Zip | 79412-2714
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Country | US
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Telephone | 817-219-6964
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 85746
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN324390
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License Number State | GA
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