Provider Demographics
NPI:1174348718
Name:HORNE, VERNETA DANAE (PRSS)
Entity type:Individual
Prefix:
First Name:VERNETA
Middle Name:DANAE
Last Name:HORNE
Suffix:
Gender:F
Credentials:PRSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10333 W RENO AVE APT 2104
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73127-7179
Mailing Address - Country:US
Mailing Address - Phone:254-900-7906
Mailing Address - Fax:
Practice Address - Street 1:10333 W RENO AVE APT 2104
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73127-7179
Practice Address - Country:US
Practice Address - Phone:254-900-7906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist