Provider Demographics
NPI:1477170710
Name:HORTON, ARYNNE GABRIELLE (LP)
Entity Type:Individual
Prefix:DR
First Name:ARYNNE
Middle Name:GABRIELLE
Last Name:HORTON
Suffix:
Gender:F
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 HOSPITAL PKWY
Mailing Address - Street 2:
Mailing Address - City:BEATRICE
Mailing Address - State:NE
Mailing Address - Zip Code:68310-6906
Mailing Address - Country:US
Mailing Address - Phone:402-228-3117
Mailing Address - Fax:402-223-6565
Practice Address - Street 1:4800 HOSPITAL PKWY
Practice Address - Street 2:
Practice Address - City:BEATRICE
Practice Address - State:NE
Practice Address - Zip Code:68310-6906
Practice Address - Country:US
Practice Address - Phone:402-559-6408
Practice Address - Fax:402-559-5737
Is Sole Proprietor?:No
Enumeration Date:2020-07-02
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1101103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025287200Medicaid