Provider Demographics
NPI:1740542562
Name:HORTON, MARSHA RENEA (FNP-BC)
Entity type:Individual
Prefix:
First Name:MARSHA
Middle Name:RENEA
Last Name:HORTON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 S KANAWHA ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-6967
Mailing Address - Country:US
Mailing Address - Phone:304-255-6300
Mailing Address - Fax:304-255-6301
Practice Address - Street 1:2401 S KANAWHA ST
Practice Address - Street 2:SUITE 100
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-6967
Practice Address - Country:US
Practice Address - Phone:304-255-6300
Practice Address - Fax:304-255-6301
Is Sole Proprietor?:No
Enumeration Date:2012-06-08
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV64556363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily