Healthcare Provider Details

I. General information

NPI: 1518642503
Provider Name (Legal Business Name): JANINE HORNE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2023
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6120 GRAY WOLF CT
WALDORF MD
20603-4324
US

IV. Provider business mailing address

3200 CRAIN HWY STE 302A
WALDORF MD
20603-4843
US

V. Phone/Fax

Practice location:
  • Phone: 301-848-3791
  • Fax:
Mailing address:
  • Phone: 301-848-3791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SC1501X
TaxonomyCommunity Health/Public Health Clinical Nurse Specialist
License NumberR216017
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number216017
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberR216017
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberR216017
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: