Provider Demographics
NPI:1386309110
Name:VAN HORN, JONI DAWN (RN)
Entity type:Individual
Prefix:
First Name:JONI
Middle Name:DAWN
Last Name:VAN HORN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5859 W TALAVI BLVD STE 140
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-1871
Mailing Address - Country:US
Mailing Address - Phone:602-806-0357
Mailing Address - Fax:
Practice Address - Street 1:5859 W TALAVI BLVD STE 140
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-1871
Practice Address - Country:US
Practice Address - Phone:602-806-0357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-06
Last Update Date:2021-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN081480207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease