Provider Demographics
NPI:1063068393
Name:HORAN, KACY (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:KACY
Middle Name:
Last Name:HORAN
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 RUTLAND DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-6063
Mailing Address - Country:US
Mailing Address - Phone:713-518-7955
Mailing Address - Fax:
Practice Address - Street 1:13435 N US HIGHWAY 183 STE 302
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-3258
Practice Address - Country:US
Practice Address - Phone:512-250-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-13
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP142486363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily