Provider Demographics
NPI:1790142339
Name:HORTON, ELIZABETH LONGINOTTI (RN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:LONGINOTTI
Last Name:HORTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 ALBANY LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOPE
Mailing Address - State:WV
Mailing Address - Zip Code:25880-9648
Mailing Address - Country:US
Mailing Address - Phone:540-718-3935
Mailing Address - Fax:
Practice Address - Street 1:115 ALBANY LN
Practice Address - Street 2:
Practice Address - City:MOUNT HOPE
Practice Address - State:WV
Practice Address - Zip Code:25880-9648
Practice Address - Country:US
Practice Address - Phone:540-718-3935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-27
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV88375163WM0102X, 163WN0003X, 163WX0002X, 163WX0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WN0003XNursing Service ProvidersRegistered NurseNeonatal, Low-Risk
No163WX0002XNursing Service ProvidersRegistered NurseObstetric, High-Risk
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient