Provider Demographics
NPI:1669990107
Name:HORTON, MEAGAN CARBONIE (CRNP)
Entity type:Individual
Prefix:MRS
First Name:MEAGAN
Middle Name:CARBONIE
Last Name:HORTON
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 1:8107 RETREAT CIR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-7375
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:143 WHITE OAK TRL
Practice Address - Street 2:
Practice Address - City:WARRIOR
Practice Address - State:AL
Practice Address - Zip Code:35180-5736
Practice Address - Country:US
Practice Address - Phone:205-476-1819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-05
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-148856390200000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program