Provider Demographics
NPI:1811332687
Name:HORTON, MONA (RN)
Entity type:Individual
Prefix:MRS
First Name:MONA
Middle Name:
Last Name:HORTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:691 RIVERLAND DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-2724
Mailing Address - Country:US
Mailing Address - Phone:843-762-8125
Mailing Address - Fax:843-762-6203
Practice Address - Street 1:691 RIVERLAND DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-2724
Practice Address - Country:US
Practice Address - Phone:843-762-8125
Practice Address - Fax:843-762-6203
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC39690163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool