Individual
JACQUELINE KAYE HORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
606 LINCOLNWAY STE B, VALPARAISO, IN 46383-5728
(219) 247-4003
Mailing address
606 LINCOLNWAY, VALPARAISO, IN 46383-5728
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
041378331
IL
163WG0000X
General Practice Registered Nurse
28228659A
IN
363L00000X
Nurse Practitioner
209016582
IL
363L00000X
Nurse Practitioner
Primary
71014248A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209016582
IDPR
IL
Enumeration date
07/17/2017
Last updated
10/17/2023
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