Provider Demographics
NPI:1033710272
Name:HORN, GARTH H (FNP)
Entity Type:Individual
Prefix:
First Name:GARTH
Middle Name:H
Last Name:HORN
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:457 E MADISON ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:MS
Mailing Address - Zip Code:38851-2308
Mailing Address - Country:US
Mailing Address - Phone:662-456-4277
Mailing Address - Fax:662-456-9589
Practice Address - Street 1:457 E MADISON ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:MS
Practice Address - Zip Code:38851-2308
Practice Address - Country:US
Practice Address - Phone:662-456-4277
Practice Address - Fax:662-456-9589
Is Sole Proprietor?:No
Enumeration Date:2020-11-04
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS904269363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care