Healthcare Provider Details

I. General information

NPI: 1003587338
Provider Name (Legal Business Name): SUSAN LEIGH HORNE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2021
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

386 BEN BOLT AVE
TAZEWELL VA
24651-5386
US

IV. Provider business mailing address

PO BOX 297
MEADOWVIEW VA
24361-0297
US

V. Phone/Fax

Practice location:
  • Phone: 276-979-9899
  • Fax: 276-979-9798
Mailing address:
  • Phone: 276-496-4492
  • Fax: 276-496-0057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024182683
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024182683
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: