Provider Demographics
NPI:1457528887
Name:HORSTMANN, LINDA (LBSW MED)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:HORSTMANN
Suffix:
Gender:F
Credentials:LBSW MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 89 BOX 560H
Mailing Address - Street 2:
Mailing Address - City:WILLOW
Mailing Address - State:AK
Mailing Address - Zip Code:99688-9707
Mailing Address - Country:US
Mailing Address - Phone:907-733-3368
Mailing Address - Fax:
Practice Address - Street 1:17040 EAST MONTANA CREEK ROAD
Practice Address - Street 2:
Practice Address - City:WILLOW
Practice Address - State:AK
Practice Address - Zip Code:99688-9707
Practice Address - Country:US
Practice Address - Phone:907-733-3368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-14
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator