Provider Demographics
NPI:1710370853
Name:HORN, TONYA R
Entity Type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:R
Last Name:HORN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 MEDLEY DR
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-1043
Mailing Address - Country:US
Mailing Address - Phone:330-899-0547
Mailing Address - Fax:
Practice Address - Street 1:1402 MEDLEY DR
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-1043
Practice Address - Country:US
Practice Address - Phone:330-899-0547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-13
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant