Provider Demographics
NPI:1992500730
Name:BARTH, IYANA ROSE I
Entity type:Individual
Prefix:
First Name:IYANA
Middle Name:ROSE
Last Name:BARTH
Suffix:I
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2511 JONES ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-1618
Mailing Address - Country:US
Mailing Address - Phone:402-507-8106
Mailing Address - Fax:
Practice Address - Street 1:7525 PIERCE PLZ APT 1
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-1510
Practice Address - Country:US
Practice Address - Phone:402-397-4961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372500000XNursing Service Related ProvidersChore ProviderGroup - Single Specialty