Provider Demographics
NPI:1528352945
Name:HORSLEY-SILVA, JENNIFER
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:HORSLEY-SILVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13400 EAST SHEA BOULEVARD
Mailing Address - Street 2:PROVIDER ENROLLMENT
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259
Mailing Address - Country:US
Mailing Address - Phone:480-301-6990
Mailing Address - Fax:480-301-8673
Practice Address - Street 1:13400 EAST SHEA BOULEVARD
Practice Address - Street 2:PROVIDER ENROLLMENT
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85259
Practice Address - Country:US
Practice Address - Phone:480-301-6990
Practice Address - Fax:480-301-8673
Is Sole Proprietor?:No
Enumeration Date:2011-06-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN62352207RG0100X
AZ49102207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology