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General NPI Number Information
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NPI Number | 1134142391
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Entity Type | Individual
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Provider Name | LILLIAN RAE HORNE M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 01/08/2021
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Provider Practice Location Address
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Address Line | 3301 TERMINAL DR
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City | RALEIGH
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State | NC
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Zip | 27604-1997
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Country | US
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Telephone | 919-814-2727
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Fax | 800-213-4920
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Provider Business Mailing Address
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Address Line | 530 BLUESTONE RD
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City | DURHAM
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State | NC
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Zip | 27713-1955
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Country | US
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Telephone | 919-361-4766
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 29751
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License Number State | NC
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