Provider Demographics
NPI:1225871353
Name:HORTON, NICOLE ALYSE (MS)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:ALYSE
Last Name:HORTON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 E WEISHEIMER RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-2147
Mailing Address - Country:US
Mailing Address - Phone:513-479-7246
Mailing Address - Fax:
Practice Address - Street 1:199 E WEISHEIMER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-2147
Practice Address - Country:US
Practice Address - Phone:513-479-7246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH70.000862170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS