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Individual

MRS. WANDA L HORN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MHNP

Contact information

Practice address
612 STATE HIGHWAY 25 S, BLOOMFIELD, MO 63825-9566
(573) 803-3995
(573) 803-5222
Mailing address
612 HWY 25 SOUTH, BLOOMFIELD, MO 63825-9566
(573) 568-7377
(573) 568-7320

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
126560
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
126560
MISSOURI STATE BOARD OF NURSING LICENSE
MO
Enumeration date
05/19/2010
Last updated
08/08/2023
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