Provider Demographics
NPI:1316712805
Name:VANHORN, KURTIS JR
Entity type:Individual
Prefix:
First Name:KURTIS
Middle Name:
Last Name:VANHORN
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2328 DEERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44411-8710
Mailing Address - Country:US
Mailing Address - Phone:216-331-8239
Mailing Address - Fax:
Practice Address - Street 1:2328 DEERFIELD DR
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:OH
Practice Address - Zip Code:44411-8710
Practice Address - Country:US
Practice Address - Phone:216-331-8239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No253Z00000XAgenciesIn Home Supportive Care
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant