Healthcare Provider Details

I. General information

NPI: 1336547157
Provider Name (Legal Business Name): AMY HORNE L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2014
Last Update Date: 01/11/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 E 80TH ST STE 114
BLOOMINGTON MN
55420-1462
US

IV. Provider business mailing address

1120 E 80TH ST STE 114
BLOOMINGTON MN
55420-1462
US

V. Phone/Fax

Practice location:
  • Phone: 612-567-2470
  • Fax:
Mailing address:
  • Phone: 612-567-2470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number1684
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: