Individual
MR. TODD CLARK VAN HORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
115 E 52ND ST, KEARNEY, NE 68847-0502
(308) 236-5506
(308) 236-7089
Mailing address
PO BOX 1771, KEARNEY, NE 68848-1771
(308) 236-5506
(308) 236-7089
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
101021
NE
367500000X
Certified Registered Nurse Anesthetist
Primary
55043
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100413860B
—
KS
05
—
47068752615
—
NE
Enumeration date
10/13/2006
Last updated
01/11/2010
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