Provider Demographics
NPI:1447051164
Name:MARRS, DAWAYNA
Entity type:Individual
Prefix:
First Name:DAWAYNA
Middle Name:
Last Name:MARRS
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 1:3488 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68111-3641
Mailing Address - Country:US
Mailing Address - Phone:402-880-9100
Mailing Address - Fax:
Practice Address - Street 1:1313 N 111TH PLZ APT 1318
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-4584
Practice Address - Country:US
Practice Address - Phone:402-505-2542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE131888376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide