Provider Demographics
NPI:1255933065
Name:HORTON, DEANNA
Entity type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:
Last Name:HORTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1029 FAIRFIELD LN
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-2743
Mailing Address - Country:US
Mailing Address - Phone:256-652-7612
Mailing Address - Fax:
Practice Address - Street 1:2010 BROOKWOOD MEDICAL CTR DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6804
Practice Address - Country:US
Practice Address - Phone:205-877-2000
Practice Address - Fax:205-877-2997
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13133183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist