Provider Demographics
NPI:1699318881
Name:HORTON, CAROLYN JEAN (BSN)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:JEAN
Last Name:HORTON
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11518 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93307-9148
Mailing Address - Country:US
Mailing Address - Phone:661-366-8625
Mailing Address - Fax:661-363-4631
Practice Address - Street 1:11518 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93307-9148
Practice Address - Country:US
Practice Address - Phone:661-366-8625
Practice Address - Fax:661-363-4631
Is Sole Proprietor?:No
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA504935163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool