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NPI Code Detail

MEDICARE: SANDRA JEAN VANHORN MSN, AGCPNP-C

MEDICARE: SANDRA JEAN VANHORN MSN, AGCPNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse PractitionerARNP 1758092FL
2363LG0600XGerontology Nurse PractitionerARNP1758092FL

General Provider Information

NPI Number : 1225422660
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDRA JEAN VANHORN MSN, AGCPNP-C
Provider Business Mailing Address
First Line : 101 S WESTMORELAND DR
Second Line :
City : ORLANDO
State : FL
Zip : 32805-2258
Country : US
Telephone Number : 407-863-9263
Fax Number : 407-836-7163
Provider Business Practice Location Address
First Line : 101 S WESTMORELAND DR
Second Line :
City : ORLANDO
State : FL
Zip : 32805-2258
Country : US
Telephone Number : 407-863-9263
Fax Number : 407-836-7163
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2015
Last Update Date : 03/03/2016

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