1528801693 NPI number — MRS. JESSICA LYNN HORNER DNP, FNP-C, APRN

Table of content: MRS. JESSICA LYNN HORNER DNP, FNP-C, APRN (NPI 1528801693)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528801693 NPI number — MRS. JESSICA LYNN HORNER DNP, FNP-C, APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HORNER
Provider First Name:
JESSICA
Provider Middle Name:
LYNN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
DNP, FNP-C, APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TERNES
Provider Other First Name:
JESSICA
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1528801693
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/09/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 5074
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SIOUX FALLS
Provider Business Mailing Address State Name:
SD
Provider Business Mailing Address Postal Code:
57117-5074
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
701-667-5100
Provider Business Mailing Address Fax Number:
701-667-5095

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
910 18TH ST NW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MANDAN
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58554-1612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-667-5100
Provider Business Practice Location Address Fax Number:
701-667-5095
Provider Enumeration Date:
06/17/2024

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  R36465 , registered in the state of ND ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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