Provider Demographics
NPI:1487867495
Name:HORNER, ANGELA LYNNE (RN)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:LYNNE
Last Name:HORNER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 CHASE CIR
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37398-5366
Mailing Address - Country:US
Mailing Address - Phone:931-967-9329
Mailing Address - Fax:
Practice Address - Street 1:GRUNDY COUNTY HEALTH DEPARTMENT
Practice Address - Street 2:1372 MAIN STREET
Practice Address - City:ALTAMONT
Practice Address - State:TN
Practice Address - Zip Code:37301
Practice Address - Country:US
Practice Address - Phone:931-692-3641
Practice Address - Fax:931-692-2201
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1089816163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health