Provider Demographics
NPI:1407980642
Name:NELSON-HORNE, SUSAN THERESA (LNP)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:THERESA
Last Name:NELSON-HORNE
Suffix:
Gender:F
Credentials:LNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 CHESHIRE ST
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-2140
Mailing Address - Country:US
Mailing Address - Phone:740-369-1650
Mailing Address - Fax:
Practice Address - Street 1:129 FIELDCREST DR
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-7622
Practice Address - Country:US
Practice Address - Phone:740-362-0172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 103789164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse