Provider Demographics
NPI:1205805959
Name:HORAN, JANIS E (NP)
Entity type:Individual
Prefix:
First Name:JANIS
Middle Name:E
Last Name:HORAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1908 N PARK RD
Mailing Address - Street 2:
Mailing Address - City:CONNERSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47331-2810
Mailing Address - Country:US
Mailing Address - Phone:765-827-0876
Mailing Address - Fax:765-825-5454
Practice Address - Street 1:1473 SR 44
Practice Address - Street 2:
Practice Address - City:CONNERSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47331-8374
Practice Address - Country:US
Practice Address - Phone:765-825-0511
Practice Address - Fax:765-827-1247
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN71001128A363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200508170Medicaid
Q24881Medicare UPIN
IN200508170Medicaid