Provider Demographics
NPI:1659184695
Name:HORSTMAN, DEANNA SULLIVAN (APRN, AGCNS-BC)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:SULLIVAN
Last Name:HORSTMAN
Suffix:
Gender:F
Credentials:APRN, AGCNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 ROSEINE DR
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-8561
Mailing Address - Country:US
Mailing Address - Phone:907-342-2928
Mailing Address - Fax:
Practice Address - Street 1:124 ROSEINE DR
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-8561
Practice Address - Country:US
Practice Address - Phone:907-342-2928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGAA-CNS001172364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health