Provider Demographics
NPI:1962260182
Name:HORST, NOELLE ELISABETH
Entity type:Individual
Prefix:
First Name:NOELLE
Middle Name:ELISABETH
Last Name:HORST
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 1:387 COUNTY HIGHWAY 146
Mailing Address - Street 2:
Mailing Address - City:GLOVERSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12078-7032
Mailing Address - Country:US
Mailing Address - Phone:151-877-5320
Mailing Address - Fax:
Practice Address - Street 1:387 COUNTY HIGHWAY 146
Practice Address - Street 2:
Practice Address - City:GLOVERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12078-7032
Practice Address - Country:US
Practice Address - Phone:151-877-5320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171M00000X171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator