Provider Demographics
NPI:1164237848
Name:TITSWORTH, TAIRA ARLETTE
Entity type:Individual
Prefix:MS
First Name:TAIRA
Middle Name:ARLETTE
Last Name:TITSWORTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2504 HARTMAN AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68111-1336
Mailing Address - Country:US
Mailing Address - Phone:531-375-9772
Mailing Address - Fax:
Practice Address - Street 1:2504 HARTMAN AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68111-1336
Practice Address - Country:US
Practice Address - Phone:531-375-9772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide