Provider Demographics
NPI:1730612730
Name:HORNER, ASHLEE (DPM)
Entity type:Individual
Prefix:
First Name:ASHLEE
Middle Name:
Last Name:HORNER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 SALT LICK RD
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-5974
Mailing Address - Country:US
Mailing Address - Phone:636-279-1900
Mailing Address - Fax:866-337-1858
Practice Address - Street 1:203 SALT LICK RD
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-5974
Practice Address - Country:US
Practice Address - Phone:636-279-1900
Practice Address - Fax:866-337-1858
Is Sole Proprietor?:No
Enumeration Date:2017-04-06
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN796 - ACADEMIC213E00000X
MO2019023039213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist