Provider Demographics
NPI:1104586361
Name:HORTON, NEKIMA L
Entity type:Individual
Prefix:MS
First Name:NEKIMA
Middle Name:L
Last Name:HORTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 N ERVAY ST UNIT 132275
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75313-0223
Mailing Address - Country:US
Mailing Address - Phone:469-493-6089
Mailing Address - Fax:
Practice Address - Street 1:1660 GINGER DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75146-4937
Practice Address - Country:US
Practice Address - Phone:469-493-6089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker