Individual
KIMBERLY RAE HORNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AG-ACNP BC
Contact information
Practice address
228 W 4TH ST STE 200, COOKEVILLE, TN 38501-2489
(931) 372-0405
(931) 372-0463
Mailing address
127 N OAK AVE, SUITE D, COOKEVILLE, TN 38501-2435
(931) 783-5857
(931) 526-6760
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
20610
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6055560
BCBS
TN
05
—
7100421130
—
KY
05
—
Q018245
—
TN
Enumeration date
10/26/2015
Last updated
01/04/2022
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