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NPI Code Detail

MEDICARE: DAESHAWN TYREE TOLBERT

MEDICARE: DAESHAWN TYREE TOLBERT
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
1374U00000XHome Health Aide

General Provider Information

NPI Number : 1235930850
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAESHAWN TYREE TOLBERT
Provider Business Mailing Address
First Line : 2118 N 24TH ST STE 108
Second Line :
City : OMAHA
State : NE
Zip : 68110-2312
Country : US
Telephone Number : 402-707-1053
Fax Number :
Provider Business Practice Location Address
First Line : 2118 N 24TH ST STE 108
Second Line :
City : OMAHA
State : NE
Zip : 68110-2312
Country : US
Telephone Number : 402-707-1053
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2025
Last Update Date : 03/20/2025

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Directions to “ DAESHAWN TYREE TOLBERT ” Practice Location

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