Healthcare Provider Details

I. General information

NPI: 1487867495
Provider Name (Legal Business Name): ANGELA LYNNE HORNER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GRUNDY COUNTY HEALTH DEPARTMENT 1372 MAIN STREET
ALTAMONT TN
37301
US

IV. Provider business mailing address

73 CHASE CIR
WINCHESTER TN
37398-5366
US

V. Phone/Fax

Practice location:
  • Phone: 931-692-3641
  • Fax: 931-692-2201
Mailing address:
  • Phone: 931-967-9329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number1089816
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: