Provider Demographics
NPI:1518642503
Name:HORNE, JANINE (RN)
Entity Type:Individual
Prefix:
First Name:JANINE
Middle Name:
Last Name:HORNE
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 1:6120 GRAY WOLF CT
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-4324
Mailing Address - Country:US
Mailing Address - Phone:301-848-3791
Mailing Address - Fax:
Practice Address - Street 1:6120 GRAY WOLF CT
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603-4324
Practice Address - Country:US
Practice Address - Phone:301-848-3791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR216017163WC1500X, 364SC1501X, 171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No364SC1501XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCommunity Health/Public Health