Provider Demographics
NPI:1922847250
Name:HORNER, ALICIA MARIE (CNP)
Entity type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:MARIE
Last Name:HORNER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7665 WESTFIELD RD
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-8500
Mailing Address - Country:US
Mailing Address - Phone:216-299-1800
Mailing Address - Fax:
Practice Address - Street 1:6707 POWERS BLVD STE 106
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-5463
Practice Address - Country:US
Practice Address - Phone:440-886-2509
Practice Address - Fax:440-886-2547
Is Sole Proprietor?:No
Enumeration Date:2024-05-24
Last Update Date:2024-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0036522363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHAPRN.CNP.0036522OtherOHIO ELICENSE OHIO PROFESSIONAL LICENSURE