Healthcare Provider Details

I. General information

NPI: 1225420151
Provider Name (Legal Business Name): AMY D HORNER MPH, RD, CLC, RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2015
Last Update Date: 07/25/2024
Certification Date: 07/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 S LEWIS AND CLARK TRL
WHITEHALL MT
59759-9547
US

IV. Provider business mailing address

67 S LEWIS AND CLARK TRL
WHITEHALL MT
59759-9547
US

V. Phone/Fax

Practice location:
  • Phone: 406-209-3995
  • Fax: 406-451-0551
Mailing address:
  • Phone: 406-209-3995
  • Fax: 406-451-0551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number408
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: