Provider Demographics
NPI:1104461292
Name:HORN, MEGAN
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:HORN
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 1:109 HUNTERS MILL RD
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-3023
Mailing Address - Country:US
Mailing Address - Phone:404-939-1723
Mailing Address - Fax:
Practice Address - Street 1:109 HUNTERS MILL RD
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-3023
Practice Address - Country:US
Practice Address - Phone:404-939-1723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula