Provider Demographics
NPI:1558958868
Name:HORNE, ANNE MARIE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:MARIE
Last Name:HORNE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:MARIE
Other - Last Name:COPELAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26001 S EASTGATE AVE
Mailing Address - Street 2:
Mailing Address - City:MONEE
Mailing Address - State:IL
Mailing Address - Zip Code:60449-8167
Mailing Address - Country:US
Mailing Address - Phone:815-735-8610
Mailing Address - Fax:
Practice Address - Street 1:14255 CICERO AVE
Practice Address - Street 2:
Practice Address - City:CRESTWOOD
Practice Address - State:IL
Practice Address - Zip Code:60418-2154
Practice Address - Country:US
Practice Address - Phone:708-371-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209022031363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily