Basic Information
Provider Information
NPI: 1174978985
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HORTON
FirstName: LINDSAY
MiddleName: D
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 550
Address2:  
City: LOWELL
State: AR
PostalCode: 72745
CountryCode: US
TelephoneNumber: 4794637775
FaxNumber: 4794637187
Practice Location
Address1: 2 EAST APPLEBY RD.
Address2: SUITE 201
City: FAYETTEVILLE
State: AR
PostalCode: 72703
CountryCode: US
TelephoneNumber: 4794041100
FaxNumber: 4794041101
Other Information
ProviderEnumerationDate: 04/29/2016
LastUpdateDate: 01/29/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XA004722ARY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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