Individual provider Active NPI

Georgia Ann Horner, RN BSN CDE

  • Diabetes Educator Registered Nurse
  • Mount Pleasant, WI
National Provider Identifier
1376016196
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diabetes Educator Registered NurseTaxonomy code 163WD0400X
License
91360 Issued in WI
Practice address
3805A Spring St Ste 311
Mount Pleasant, WI 53405-1600
Phone
(262) 687-6345
Fax
(262) 687-6344
NPI assigned
Jan 3, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered Nurse 163WD0400X 91360 WI Primary

Addresses

Primary practice location

3805A Spring St Ste 311
Mount Pleasant, WI 53405-1600

Mailing address

3805A Spring St Ste 311
Mount Pleasant, WI 53405-1600
Phone (262) 687-6345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
91360WIMDDiabetes Educator Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1546473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1376016196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3805A SPRING ST STE 311",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534051600",
            "telephone_number": "262-687-6345",
            "fax_number": "262-687-6344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805A SPRING ST STE 311",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534051600",
            "telephone_number": "262-687-6345",
            "fax_number": "262-687-6344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORNER",
        "first_name": "GEORGIA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RN BSN CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-03",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "WI",
            "license": "91360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.