Provider Demographics
NPI:1831997980
Name:HORTON, SHAWN
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:
Last Name:HORTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1029 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:OH
Mailing Address - Zip Code:43078-2541
Mailing Address - Country:US
Mailing Address - Phone:937-450-3636
Mailing Address - Fax:
Practice Address - Street 1:1029 S MAIN ST
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:OH
Practice Address - Zip Code:43078-2541
Practice Address - Country:US
Practice Address - Phone:937-450-3636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide