Provider Demographics
NPI:1558537563
Name:HORAN, ANNE REGINA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:REGINA
Last Name:HORAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:113 NORTH WASHINGTON STREET
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314
Mailing Address - Country:US
Mailing Address - Phone:703-549-5454
Mailing Address - Fax:703-549-7872
Practice Address - Street 1:113 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-3022
Practice Address - Country:US
Practice Address - Phone:703-549-5454
Practice Address - Fax:703-549-7872
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101057392207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAE85641Medicare UPIN