Healthcare Provider Details

I. General information

NPI: 1407635584
Provider Name (Legal Business Name): DONNA MARIE HORTON DNP, CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2023
Last Update Date: 09/27/2023
Certification Date: 09/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3651 WHEELER RD
AUGUSTA GA
30909-6426
US

IV. Provider business mailing address

506 WOOD FOREST TRL
APPLING GA
30802-3349
US

V. Phone/Fax

Practice location:
  • Phone: 706-651-3232
  • Fax:
Mailing address:
  • Phone: 706-836-4327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN207916
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: