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General NPI Number Information
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NPI Number | 1659964153
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Entity Type | Individual
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Provider Name | AMY SUZANNE HORNER APN
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Gender | Female
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Dates
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Enumeration Date | 02/16/2021
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Last Update Date | 02/16/2021
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Provider Practice Location Address
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Address Line | 10915 N RODNEY PARHAM RD STE B
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City | LITTLE ROCK
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State | AR
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Zip | 72212-4202
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Country | US
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Telephone | 501-747-2828
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Fax | 501-747-2868
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Provider Business Mailing Address
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Address Line | PO BOX 26618
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City | LITTLE ROCK
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State | AR
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Zip | 72221-6601
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Country | US
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Telephone | 501-747-2828
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Fax | 501-474-2868
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 125408
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License Number State | AR
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