Provider Demographics
NPI:1063547040
Name:HALL-HORNER, KIMBERLY (RPH)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:
Last Name:HALL-HORNER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PUNXSUTAWNEY
Mailing Address - State:PA
Mailing Address - Zip Code:15767-2419
Mailing Address - Country:US
Mailing Address - Phone:814-938-3156
Mailing Address - Fax:
Practice Address - Street 1:132 W MAHONING ST
Practice Address - Street 2:
Practice Address - City:PUNXSUTAWNEY
Practice Address - State:PA
Practice Address - Zip Code:15767-2017
Practice Address - Country:US
Practice Address - Phone:814-938-3077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP040951L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist