Basic Information
| Provider Information | |||||||||
| NPI: | 1073114872 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HORINE | ||||||||
| FirstName: | HAROLD | ||||||||
| MiddleName: | JAMES | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | III | ||||||||
| Credential: | DNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 43 MEADOW LARK LN | ||||||||
| Address2: | |||||||||
| City: | DEER LODGE | ||||||||
| State: | MT | ||||||||
| PostalCode: | 597229540 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4064909391 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 445 CENTENNIAL AVE | ||||||||
| Address2: | |||||||||
| City: | BUTTE | ||||||||
| State: | MT | ||||||||
| PostalCode: | 597012870 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4067234075 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/06/2020 | ||||||||
| LastUpdateDate: | 10/01/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 163627 | MT | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.