Provider Demographics
NPI:1548055809
Name:HORINE, NATALIE
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:HORINE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:
Other - Last Name:STAGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:928 S J ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN BOW
Mailing Address - State:NE
Mailing Address - Zip Code:68822-2471
Mailing Address - Country:US
Mailing Address - Phone:308-880-9267
Mailing Address - Fax:
Practice Address - Street 1:428 N 5TH AVE
Practice Address - Street 2:
Practice Address - City:BROKEN BOW
Practice Address - State:NE
Practice Address - Zip Code:68822-1708
Practice Address - Country:US
Practice Address - Phone:308-880-9257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372600000XNursing Service Related ProvidersAdult Companion