Provider Demographics
NPI:1477024594
Name:HORNE, JENNIFER MARIE (IBCLC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MARIE
Last Name:HORNE
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 PRESTON DR
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-5038
Mailing Address - Country:US
Mailing Address - Phone:339-222-3839
Mailing Address - Fax:
Practice Address - Street 1:13 PRESTON DR
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:RI
Practice Address - Zip Code:02806-5038
Practice Address - Country:US
Practice Address - Phone:339-222-3839
Practice Address - Fax:401-216-8021
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-16
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN