Provider Demographics
NPI:1265546626
Name:HORAN, NANCY MATHES (CRNP)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:MATHES
Last Name:HORAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4524 MINUTEMAN DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-1252
Mailing Address - Country:US
Mailing Address - Phone:301-774-2838
Mailing Address - Fax:
Practice Address - Street 1:2309 SHOREFIELD RD
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:MD
Practice Address - Zip Code:20902-1853
Practice Address - Country:US
Practice Address - Phone:301-933-5050
Practice Address - Fax:301-949-3262
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR063128363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health