Healthcare Provider Details

I. General information

NPI: 1356257042
Provider Name (Legal Business Name): MRS. WHITNEY RENAE HORNBERGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1323 W 6TH AVE
STILLWATER OK
74074-4399
US

IV. Provider business mailing address

PO BOX 452
MORRISON OK
73061-0452
US

V. Phone/Fax

Practice location:
  • Phone: 405-533-4316
  • Fax:
Mailing address:
  • Phone: 405-612-5974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR0109115
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: