Provider Demographics
NPI:1144950288
Name:HORNE, SHAE'ERICA
Entity type:Individual
Prefix:
First Name:SHAE'ERICA
Middle Name:
Last Name:HORNE
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 1:113 ERICAS CT
Mailing Address - Street 2:
Mailing Address - City:FITZGERALD
Mailing Address - State:GA
Mailing Address - Zip Code:31750-8366
Mailing Address - Country:US
Mailing Address - Phone:229-736-4059
Mailing Address - Fax:
Practice Address - Street 1:113 ERICAS CT
Practice Address - Street 2:
Practice Address - City:FITZGERALD
Practice Address - State:GA
Practice Address - Zip Code:31750-8366
Practice Address - Country:US
Practice Address - Phone:229-736-4059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-13
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty