Provider Demographics
NPI:1518558642
Name:HORTON, ALISSA JEAN (RN)
Entity Type:Individual
Prefix:MS
First Name:ALISSA
Middle Name:JEAN
Last Name:HORTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
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Mailing Address - Street 1:1001 BELLEFONTAINE AVE
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-2800
Mailing Address - Country:US
Mailing Address - Phone:419-998-4575
Mailing Address - Fax:419-998-4586
Practice Address - Street 1:1220 E ELM ST STE 101
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-2803
Practice Address - Country:US
Practice Address - Phone:419-998-8245
Practice Address - Fax:419-998-8247
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH324332163WM0102X
OHAPRN.CNM.0019466367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn