Provider Demographics
NPI:1154918134
Name:HORNE, DAVID (PARAMEDIC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:HORNE
Suffix:
Gender:M
Credentials:PARAMEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9105 N LITEN GATA CIR
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-9220
Mailing Address - Country:US
Mailing Address - Phone:907-390-0949
Mailing Address - Fax:
Practice Address - Street 1:9105 N LITEN GATA CIR
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-9220
Practice Address - Country:US
Practice Address - Phone:907-390-0949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-24
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK142653146L00000X
AK123456789101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Multi-Specialty