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Individual

KEVIN HORN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
ARNP

Contact information

Practice address
311 NW 250TH ST, NEWBERRY, FL 32669-4454
(352) 472-6776
(352) 472-6778
Mailing address
789 W DUVAL ST, LAKE CITY, FL 32055-3811
(386) 755-5044
(386) 755-2518

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
ARNP9224044
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3065758000
FL
Enumeration date
02/03/2006
Last updated
07/08/2007
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