MEDICARE: DR. NICHELLE R HORTON-BROWN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RA0000X	Adolescent Medicine (Internal Medicine) Physician	22626	NE

General Provider Information

NPI Number	:	1154376267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICHELLE R HORTON-BROWN MD

Provider Business Mailing Address
First Line	:	3015 N 90TH ST STE 1
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68134-4713
Country	:	US
Telephone Number	:	402-453-6869
Fax Number	:	402-453-6869

Provider Business Practice Location Address
First Line	:	3015 N 90TH ST STE 1
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68134-4713
Country	:	US
Telephone Number	:	402-453-6869
Fax Number	:	402-961-1055

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	09/12/2023

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