Provider Demographics
NPI:1457050734
Name:HORN, CHRISTA ANNETTE (CNM)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTA
Middle Name:ANNETTE
Last Name:HORN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1577 HILLTOP RD
Mailing Address - Street 2:
Mailing Address - City:JEWELL RIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:24622-9302
Mailing Address - Country:US
Mailing Address - Phone:276-202-0311
Mailing Address - Fax:
Practice Address - Street 1:317 N HICKORY AVE
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-2428
Practice Address - Country:US
Practice Address - Phone:931-528-7527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33525367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife