Provider Demographics
NPI:1124504105
Name:HORNE, JAMI (AGACNP)
Entity type:Individual
Prefix:
First Name:JAMI
Middle Name:
Last Name:HORNE
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 PINEHURST BYROMVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:GA
Mailing Address - Zip Code:31070-7451
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1062 FORSYTH ST STE 1B
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-8638
Practice Address - Country:US
Practice Address - Phone:478-741-1208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-13
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN232369363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty