Provider Demographics
NPI:1730176330
Name:HORN, CYNTHIA (FNP)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:HORN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26334 DAVIS RD
Mailing Address - Street 2:
Mailing Address - City:KERSEY
Mailing Address - State:CO
Mailing Address - Zip Code:80644-9714
Mailing Address - Country:US
Mailing Address - Phone:970-304-6420
Mailing Address - Fax:970-304-6421
Practice Address - Street 1:1555 N 17TH AVE
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-9117
Practice Address - Country:US
Practice Address - Phone:970-304-6420
Practice Address - Fax:970-304-6421
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-29
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO124285363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO18051375Medicaid
COMH0838758OtherDEA
CO801320Medicare ID - Type Unspecified
CO18051375Medicaid