Provider Demographics
NPI:1700767498
Name:SPORVEN, SYDNI J
Entity type:Individual
Prefix:
First Name:SYDNI
Middle Name:J
Last Name:SPORVEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SYDNI
Other - Middle Name:J
Other - Last Name:MLADY-SPORVEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3011 S 9TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68108-1604
Mailing Address - Country:US
Mailing Address - Phone:402-718-7456
Mailing Address - Fax:
Practice Address - Street 1:3011 S 9TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68108-1604
Practice Address - Country:US
Practice Address - Phone:402-718-7456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-09
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion