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General NPI Number Information
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NPI Number | 1669584835
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Entity Type | Individual
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Provider Name | JILL ELAINE VAN HORN DO
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 02/09/2015
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Provider Practice Location Address
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Address Line | 1499 MAIN ST
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City | YANCEYVILLE
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State | NC
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Zip | 27379-8793
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Country | US
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Telephone | 336-694-6969
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Fax | 336-694-1266
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Provider Business Mailing Address
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Address Line | 142 S MAIN ST
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City | DANVILLE
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State | VA
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Zip | 24541-2922
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Country | US
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Telephone | 336-694-6969
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Fax | 336-694-1266
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A8528
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2014-02435
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License Number State | NC
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