Provider Demographics
NPI:1689400715
Name:HORNE, STACY KAY
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:KAY
Last Name:HORNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3610 BATTLESBURG ST SE
Mailing Address - Street 2:
Mailing Address - City:EAST SPARTA
Mailing Address - State:OH
Mailing Address - Zip Code:44626-9543
Mailing Address - Country:US
Mailing Address - Phone:330-324-3740
Mailing Address - Fax:
Practice Address - Street 1:3610 BATTLESBURG ST SE
Practice Address - Street 2:
Practice Address - City:EAST SPARTA
Practice Address - State:OH
Practice Address - Zip Code:44626-9543
Practice Address - Country:US
Practice Address - Phone:330-324-3740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist