Provider Demographics
NPI:1760237309
Name:HORNSBY, JENNA ALEECE
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:ALEECE
Last Name:HORNSBY
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 1:7262 GREAT OAKS RD
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-2709
Mailing Address - Country:US
Mailing Address - Phone:901-826-7624
Mailing Address - Fax:
Practice Address - Street 1:930 MADISON AVE FL 6
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-3461
Practice Address - Country:US
Practice Address - Phone:901-448-8393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program