Provider Demographics
NPI:1255748612
Name:HORN, CAROL-JANE (BSN, RN, IBCLC, RLC)
Entity type:Individual
Prefix:
First Name:CAROL-JANE
Middle Name:
Last Name:HORN
Suffix:
Gender:F
Credentials:BSN, RN, IBCLC, RLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4649 HIGH POINT RD
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-2811
Mailing Address - Country:US
Mailing Address - Phone:404-408-2724
Mailing Address - Fax:
Practice Address - Street 1:4649 HIGH POINT RD
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-2811
Practice Address - Country:US
Practice Address - Phone:404-408-2724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-17
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA13017163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant