Provider Demographics
NPI:1790545804
Name:HORVERS, ELENA
Entity Type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:HORVERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 SUN VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29550-8783
Mailing Address - Country:US
Mailing Address - Phone:518-833-5864
Mailing Address - Fax:
Practice Address - Street 1:632 SUN VALLEY DR
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29550-8783
Practice Address - Country:US
Practice Address - Phone:518-833-5864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC52969164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse