Provider Demographics
NPI:1598103368
Name:HORTON, MEGAN LEANN (PA)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:LEANN
Last Name:HORTON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:PO BOX 751803
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1803
Mailing Address - Country:US
Mailing Address - Phone:336-718-8383
Mailing Address - Fax:336-718-9622
Practice Address - Street 1:7130 VILLAGE MEDICAL CIR
Practice Address - Street 2:
Practice Address - City:CLEMMONS
Practice Address - State:NC
Practice Address - Zip Code:27012-8004
Practice Address - Country:US
Practice Address - Phone:336-893-2420
Practice Address - Fax:336-893-2431
Is Sole Proprietor?:No
Enumeration Date:2013-06-13
Last Update Date:2023-11-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC001004297363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant