Provider Demographics
NPI:1851192850
Name:IWEZOR, DORIS O
Entity type:Individual
Prefix:
First Name:DORIS
Middle Name:O
Last Name:IWEZOR
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 1:3225 FOLKWAYS BLVD APT 1A
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68504-1292
Mailing Address - Country:US
Mailing Address - Phone:803-908-7745
Mailing Address - Fax:
Practice Address - Street 1:2610 W M CT
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68522-1006
Practice Address - Country:US
Practice Address - Phone:402-325-8555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist