Provider Demographics
NPI:1962711325
Name:HORNER, NATASHA RODRIGUEZ (CRNP)
Entity type:Individual
Prefix:MRS
First Name:NATASHA
Middle Name:RODRIGUEZ
Last Name:HORNER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 45TH AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35476-6724
Mailing Address - Country:US
Mailing Address - Phone:334-341-1252
Mailing Address - Fax:
Practice Address - Street 1:100 RICE MINE ROAD LOOP STE 206
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-2418
Practice Address - Country:US
Practice Address - Phone:205-339-0171
Practice Address - Fax:205-333-8681
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-072415363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009930115Medicaid