Provider Demographics
NPI:1073853834
Name:HORN, PATRICIA ANNE
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANNE
Last Name:HORN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4330 E MAPLEWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80121-3355
Mailing Address - Country:US
Mailing Address - Phone:720-980-1157
Mailing Address - Fax:
Practice Address - Street 1:4330 E MAPLEWOOD WAY
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80121-3355
Practice Address - Country:US
Practice Address - Phone:720-980-1157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO41678164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse