Individual
TYSON KINZLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
18114 CINNAMON ST, OMAHA, NE 68135-1757
(531) 225-5858
Mailing address
18114 CINNAMON ST, OMAHA, NE 68135-1757
(531) 225-5858
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
376J00000X
Homemaker
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
11/12/2025
Last updated
11/12/2025
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