Provider Demographics
NPI:1962264937
Name:HORNSBY, EMMA CAROLINE
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:CAROLINE
Last Name:HORNSBY
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 1:1311 GRIST MILL DR
Mailing Address - Street 2:
Mailing Address - City:PHENIX CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36867-1329
Mailing Address - Country:US
Mailing Address - Phone:706-464-7990
Mailing Address - Fax:
Practice Address - Street 1:1311 GRIST MILL DR
Practice Address - Street 2:
Practice Address - City:PHENIX CITY
Practice Address - State:AL
Practice Address - Zip Code:36867-1329
Practice Address - Country:US
Practice Address - Phone:706-464-7990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program