Provider Demographics
NPI:1093512097
Name:WARE, TWYLA R
Entity type:Individual
Prefix:
First Name:TWYLA
Middle Name:R
Last Name:WARE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 KNOX ST APT 14
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521-1783
Mailing Address - Country:US
Mailing Address - Phone:531-893-3465
Mailing Address - Fax:
Practice Address - Street 1:1800 KNOX ST APT 14
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68521-1783
Practice Address - Country:US
Practice Address - Phone:531-893-3465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE253Z00000XMedicaid