MEDICARE: MS. MISTY J HORN FNP

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
1	363LF0000X	Family Nurse Practitioner	11971	CO
2	363LF0000X	Family Nurse Practitioner	551440	TX

General Provider Information

NPI Number	:	1881711141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MISTY J HORN FNP

Provider Business Mailing Address
First Line	:	11003 RESOURCE PKWY STE 102
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77089-6142
Country	:	US
Telephone Number	:	281-481-8557
Fax Number	:	281-481-8540

Provider Business Practice Location Address
First Line	:	11003 RESOURCE PKWY STE 102
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77089-6142
Country	:	US
Telephone Number	:	281-481-8557
Fax Number	:	281-481-8540

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	09/11/2019

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