Provider Demographics
NPI:1578288007
Name:HORNER, CAROLEE (MS, NBC-HWC)
Entity Type:Individual
Prefix:MS
First Name:CAROLEE
Middle Name:
Last Name:HORNER
Suffix:
Gender:F
Credentials:MS, NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 INDEPENDENCE PL NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-1505
Mailing Address - Country:US
Mailing Address - Phone:678-350-3747
Mailing Address - Fax:
Practice Address - Street 1:6667 VERNON WOODS DR STE B27
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-3216
Practice Address - Country:US
Practice Address - Phone:678-310-8144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist