Provider Demographics
NPI:1871244772
Name:HORTON, CARRIGAN (PA-C)
Entity Type:Individual
Prefix:
First Name:CARRIGAN
Middle Name:
Last Name:HORTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5722 INTEGRITY DR BLDG S771
Mailing Address - Street 2:
Mailing Address - City:MILLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38054-5028
Mailing Address - Country:US
Mailing Address - Phone:901-874-6100
Mailing Address - Fax:
Practice Address - Street 1:5722 INTEGRITY DR BLDG S771
Practice Address - Street 2:
Practice Address - City:MILLINGTON
Practice Address - State:TN
Practice Address - Zip Code:38054-5028
Practice Address - Country:US
Practice Address - Phone:901-874-6153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-12
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA15404363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical