Individual
MRS. CRYSTAL MARIE HORNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
209 E JEFFERSON ST, PLYMOUTH, IN 46563-1861
(574) 941-3111
(574) 335-0745
Mailing address
707 E CEDAR ST, STE 200, SOUTH BEND, IN 46617-2057
(574) 335-8700
(574) 335-0760
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28150571A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000844055
BCBS
IN
05
—
201175710
—
IN
Enumeration date
01/24/2013
Last updated
09/14/2016
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