Provider Demographics
NPI:1629828272
Name:HORNBECK, CHASITY MARIE
Entity Type:Individual
Prefix:
First Name:CHASITY
Middle Name:MARIE
Last Name:HORNBECK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHASITY
Other - Middle Name:MARIE
Other - Last Name:SKELTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:708 NORTH CHESTNUT ST
Mailing Address - Street 2:1/2
Mailing Address - City:BARNESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43713
Mailing Address - Country:US
Mailing Address - Phone:740-232-9632
Mailing Address - Fax:
Practice Address - Street 1:708 NORTH CHESTNUT ST
Practice Address - Street 2:1/2
Practice Address - City:BARNESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43713
Practice Address - Country:US
Practice Address - Phone:740-232-9632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide