Horner, Kimberly Rae

Horner, Kimberly Rae is an individual health care provider with primary practice located at 228 W 4Th St Ste 200 , Cookeville TN 38501-2489. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as her primary health care specialty. Horner, Kimberly Rae can be contacted via phone (931) 372-0405.

Contact Information

Primary practice address
228 W 4Th St Ste 200 Cookeville TN 38501-2489
Fax: (931) 372-0463
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 20610 Tennessee

Profile Details

NPI number 1083086433
LBN Legal business name Horner, Kimberly Rae
Credentials AG-ACNP BC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2015
Last updated Jan 4th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083086433 NPPES
Tennessee MEDICAID Q018245
Tennessee Other 6055560
Tennessee MEDICAID 7100421130

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