Provider Demographics
NPI:1528519956
Name:HORTON, MARIA (MSN, AGPCNP BC)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:HORTON
Suffix:
Gender:F
Credentials:MSN, AGPCNP BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4503 HANCOCK DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48642-5893
Mailing Address - Country:US
Mailing Address - Phone:989-430-7803
Mailing Address - Fax:
Practice Address - Street 1:3023 DAVENPORT AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-3652
Practice Address - Country:US
Practice Address - Phone:989-907-2761
Practice Address - Fax:989-907-2762
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-20
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704248039363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner