Provider Demographics
NPI:1083503619
Name:TOLBERT, ARTEZ T
Entity type:Individual
Prefix:
First Name:ARTEZ
Middle Name:T
Last Name:TOLBERT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3325 FONTENELLE BLVD APT 311
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104-3699
Mailing Address - Country:US
Mailing Address - Phone:402-676-8311
Mailing Address - Fax:
Practice Address - Street 1:5501 N 47TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68104-1403
Practice Address - Country:US
Practice Address - Phone:402-881-1491
Practice Address - Fax:402-881-1491
Is Sole Proprietor?:No
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker