Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 904269 | MS |
NPI | 1033710272 |
---|---|
Provider Name | Garth H Horn |
First Address | Houston, MS 38851-2308 |
Second Address | Houston, MS 38851-2308 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2020 |
Last Update Date | 22/11/2021 |