Provider Demographics
NPI:1649363953
Name:HORNER, DEVON LYNN (RD, LDN)
Entity type:Individual
Prefix:
First Name:DEVON
Middle Name:LYNN
Last Name:HORNER
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 PRINCETON DR
Mailing Address - Street 2:
Mailing Address - City:DELRAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08075-1608
Mailing Address - Country:US
Mailing Address - Phone:609-220-3339
Mailing Address - Fax:
Practice Address - Street 1:225 NEWTOWN RD
Practice Address - Street 2:
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-5221
Practice Address - Country:US
Practice Address - Phone:215-441-6952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN003558133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered