Provider Demographics
NPI:1700650140
Name:HORTON, ALICIA N
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:N
Last Name:HORTON
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 1:37 FARMINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:NEW PROVIDNCE
Mailing Address - State:PA
Mailing Address - Zip Code:17560-9428
Mailing Address - Country:US
Mailing Address - Phone:717-405-8640
Mailing Address - Fax:
Practice Address - Street 1:37 FARMINGTON WAY
Practice Address - Street 2:
Practice Address - City:NEW PROVIDNCE
Practice Address - State:PA
Practice Address - Zip Code:17560-9428
Practice Address - Country:US
Practice Address - Phone:171-740-5864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP025339363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily