Provider Demographics
NPI:1508317207
Name:HORNE, RANDI (NP-C)
Entity Type:Individual
Prefix:MS
First Name:RANDI
Middle Name:
Last Name:HORNE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2421 W 7TH ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-2305
Mailing Address - Country:US
Mailing Address - Phone:817-439-7662
Mailing Address - Fax:
Practice Address - Street 1:2421 W 7TH ST
Practice Address - Street 2:SUITE 205
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-2305
Practice Address - Country:US
Practice Address - Phone:817-439-7662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-18
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131240363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health