Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 036.140659 | IL |
N | 111NI0900X | Internist | 036.140659 | IL |
N | 207R00000X | Internist | S2342 | TX |
N | 111NI0900X | Internist | S2342 | TX |
N | 207RC0200X | Critical Care Medicine | S2342 | TX |
Y | 207RP1001X | Pulmonary Disease | S2342 | TX |
NPI | 1003158254 |
---|---|
Provider Name | Jacqueline Nicole Horst |
First Address | Chicago, IL 60612-3800 |
Second Address | Dallas, TX 75208-2312 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2013 |
Last Update Date | 26/08/2021 |