Provider Demographics
NPI:1083027957
Name:HORNE, ANDREA KRISTINE (OD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:KRISTINE
Last Name:HORNE
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5653 GATEWAY AVE APT D
Mailing Address - Street 2:
Mailing Address - City:TONTITOWN
Mailing Address - State:AR
Mailing Address - Zip Code:72762-3275
Mailing Address - Country:US
Mailing Address - Phone:479-777-2697
Mailing Address - Fax:479-763-3212
Practice Address - Street 1:5653 GATEWAY AVE APT D
Practice Address - Street 2:
Practice Address - City:TONTITOWN
Practice Address - State:AR
Practice Address - Zip Code:72762-3275
Practice Address - Country:US
Practice Address - Phone:479-777-2697
Practice Address - Fax:479-763-3212
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-08
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2822152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist