Horner, Crystal Marie

Horner, Crystal Marie is an individual health care provider with primary practice located at 209 E Jefferson St , Plymouth IN 46563-1861. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Horner, Crystal Marie can be contacted via phone (574) 941-3111.

Contact Information

Primary practice address
209 E Jefferson St Plymouth IN 46563-1861
Phone: (574) 941-3111
Fax: (574) 335-0745
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 28150571A Indiana

Profile Details

NPI number 1760720825
LBN Legal business name Horner, Crystal Marie
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 24th, 2013
Last updated Sep 14th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760720825 NPPES
Indiana Other 000000844055 BCBS
Indiana MEDICAID 201175710 BCBS

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