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NPI Code Detail

MEDICARE: MYRISA HORNBECK

MEDICARE: MYRISA HORNBECK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator
2172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1710560479
Entity Type Code : Individual
Provider Name (Legal Business Name) : MYRISA HORNBECK
Provider Business Mailing Address
First Line : 2359 KNOLLWOOD AVE
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44514-1525
Country : US
Telephone Number : 216-260-1405
Fax Number :
Provider Business Practice Location Address
First Line : 850 HOWLAND WILSON RD NE
Second Line :
City : WARREN
State : OH
Zip : 44484-2116
Country : US
Telephone Number : 216-260-1405
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2021
Last Update Date : 07/29/2024

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Directions to “ MYRISA HORNBECK ” Practice Location

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