Provider Demographics
NPI:1508300153
Name:HORSTMAN, MELANIE (IBCLC)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:HORSTMAN
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8329 CASS ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3529
Mailing Address - Country:US
Mailing Address - Phone:402-915-1559
Mailing Address - Fax:402-838-7199
Practice Address - Street 1:8329 CASS ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114
Practice Address - Country:US
Practice Address - Phone:402-915-1559
Practice Address - Fax:402-838-7199
Is Sole Proprietor?:No
Enumeration Date:2016-12-15
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN