Healthcare Provider Details

I. General information

NPI: 1750912424
Provider Name (Legal Business Name): MARIE HORNER MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2020
Last Update Date: 05/19/2021
Certification Date: 05/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 N FORGE ST
AKRON OH
44304-1407
US

IV. Provider business mailing address

486 BICKSLER DR
WADSWORTH OH
44281-1216
US

V. Phone/Fax

Practice location:
  • Phone: 330-375-7955
  • Fax:
Mailing address:
  • Phone: 330-858-0706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.026300
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.026300
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number372040
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: