Provider Demographics
NPI:1669032876
Name:HORTON, MATTHEW A (FNP-C)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:A
Last Name:HORTON
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1727
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81502-1727
Mailing Address - Country:US
Mailing Address - Phone:970-644-4030
Mailing Address - Fax:970-644-3914
Practice Address - Street 1:2503 FORESIGHT CIR UNIT B
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-1139
Practice Address - Country:US
Practice Address - Phone:970-644-4030
Practice Address - Fax:970-644-4030
Is Sole Proprietor?:No
Enumeration Date:2019-06-19
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9024277-3102163W00000X
COC-APN.0004430-C-NP174400000X, 363L00000X
UT9024277-4405363LF0000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No174400000XOther Service ProvidersSpecialist
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program