Provider Demographics
NPI:1225422660
Name:VANHORN, SANDRA JEAN (MSN, AGCPNP-C)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:JEAN
Last Name:VANHORN
Suffix:
Gender:F
Credentials:MSN, AGCPNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S WESTMORELAND DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32805-2258
Mailing Address - Country:US
Mailing Address - Phone:407-863-9263
Mailing Address - Fax:407-836-7163
Practice Address - Street 1:101 S WESTMORELAND DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32805-2258
Practice Address - Country:US
Practice Address - Phone:407-863-9263
Practice Address - Fax:407-836-7163
Is Sole Proprietor?:No
Enumeration Date:2015-03-24
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 1758092363LA2200X
FLARNP1758092363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health