Provider Demographics
NPI:1851943542
Name:HORNE, ANASTASIA MARIE (APRN)
Entity Type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:MARIE
Last Name:HORNE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4250 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:MARIANNA
Mailing Address - State:FL
Mailing Address - Zip Code:32446-1917
Mailing Address - Country:US
Mailing Address - Phone:850-718-2569
Mailing Address - Fax:
Practice Address - Street 1:4896 HIGHWAY 90 STE A
Practice Address - Street 2:
Practice Address - City:MARIANNA
Practice Address - State:FL
Practice Address - Zip Code:32446-7840
Practice Address - Country:US
Practice Address - Phone:850-526-6700
Practice Address - Fax:850-526-6701
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-12
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11003197363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily