Provider Demographics
NPI:1942831318
Name:HORNBECK, TERA MAY (DNP, RN, AGCNS-BC)
Entity Type:Individual
Prefix:DR
First Name:TERA
Middle Name:MAY
Last Name:HORNBECK
Suffix:
Gender:F
Credentials:DNP, RN, AGCNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2274 FLOWERING CRAB DR E
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47905-7729
Mailing Address - Country:US
Mailing Address - Phone:765-404-3712
Mailing Address - Fax:
Practice Address - Street 1:2274 FLOWERING CRAB DR E
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-7729
Practice Address - Country:US
Practice Address - Phone:765-404-3712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28173241A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse