Provider Demographics
NPI:1184038804
Name:HORTON, CATHERINE ANNE (LPN)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:ANNE
Last Name:HORTON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:CATHERINE
Other - Middle Name:ANNE
Other - Last Name:DODGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:1167 SPRATLIN PARK DR
Mailing Address - Street 2:POB 9054
Mailing Address - City:GRAY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-6205
Mailing Address - Country:US
Mailing Address - Phone:423-467-3600
Mailing Address - Fax:423-467-3644
Practice Address - Street 1:401 HOLSTON DR
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37743-3127
Practice Address - Country:US
Practice Address - Phone:423-639-1104
Practice Address - Fax:423-467-3644
Is Sole Proprietor?:No
Enumeration Date:2014-06-20
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0002089683164W00000X
TN84965164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse