Provider Demographics
NPI:1003524927
Name:HORNER, PAIGE E (CRNP, MSN)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:E
Last Name:HORNER
Suffix:
Gender:F
Credentials:CRNP, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2024 LEHIGH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-4938
Mailing Address - Country:US
Mailing Address - Phone:610-402-7800
Mailing Address - Fax:610-402-7912
Practice Address - Street 1:972 BUCKINGHAM DR
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-9789
Practice Address - Country:US
Practice Address - Phone:484-264-7624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP026495363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASP026495OtherPA LICENSE