Provider Demographics
NPI:1265081756
Name:WHITEHORN, DEANNA M (MSN, APRN-CNP)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:M
Last Name:WHITEHORN
Suffix:
Gender:F
Credentials:MSN, APRN-CNP
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:M
Other - Last Name:MICHELINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1155 MILL ST # M14
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1576
Mailing Address - Country:US
Mailing Address - Phone:775-982-5262
Mailing Address - Fax:775-982-5496
Practice Address - Street 1:10315 PROFESSIONAL CIR STE 101
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-4803
Practice Address - Country:US
Practice Address - Phone:775-982-2828
Practice Address - Fax:775-982-2834
Is Sole Proprietor?:No
Enumeration Date:2019-09-06
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV823643363LG0600X, 363LA2100X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV14539201OtherCAQH