Individual
NICOLE L HORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
2901 W KINNICKINNIC RIVER PKWY, MILWAUKEE, WI 53215-3677
(414) 649-3780
(414) 649-3794
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
7167
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100065052
—
WI
05
—
1588118087
—
WI
01
—
K400390380
MEDICARE
WI
Enumeration date
08/12/2016
Last updated
10/13/2023
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