Provider Demographics
NPI:1871173567
Name:HORTON, ANJENETT
Entity type:Individual
Prefix:
First Name:ANJENETT
Middle Name:
Last Name:HORTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 N GRAND RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48906-4846
Mailing Address - Country:US
Mailing Address - Phone:517-803-8784
Mailing Address - Fax:
Practice Address - Street 1:3605 BAYVIEW DR APT 106
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-2055
Practice Address - Country:US
Practice Address - Phone:517-803-7803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide