Individual
MR. GLEN ROLAND HORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2525 DESALES AVE, CHATTANOOGA, TN 37404-1161
(423) 206-5040
Mailing address
5 CALHOUN AVE, UNIT 606, DESTIN, FL 32541-5509
(404) 310-6048
(404) 255-1831
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
110691
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
9397267
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000521435B
—
GA
01
—
156961100
U.S. DEPT OF LABOR
GA
01
—
20-02624
UNITED HEALTHCARE
GA
01
—
430010318
TRI-CARE
GA
01
—
52159539-001
BLUE CROSS BLUE SHIELD
GA
01
—
9975585
UNIVERSAL HEALTHCARE
GA
Enumeration date
11/13/2006
Last updated
11/04/2024
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