Provider Demographics
NPI:1578449609
Name:HORNE, MANDY CHRISTINA (RN)
Entity type:Individual
Prefix:
First Name:MANDY
Middle Name:CHRISTINA
Last Name:HORNE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1114 WOODGLEN DR
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46074-7796
Mailing Address - Country:US
Mailing Address - Phone:317-645-6811
Mailing Address - Fax:317-215-5570
Practice Address - Street 1:1114 WOODGLEN DR
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:IN
Practice Address - Zip Code:46074-7796
Practice Address - Country:US
Practice Address - Phone:317-645-6811
Practice Address - Fax:317-215-5570
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20932H5171400000X
IN28197232A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No171400000XOther Service ProvidersHealth & Wellness Coach