Provider Demographics
NPI:1023906989
Name:IRVING, XAVIER DEWAYNE I
Entity type:Individual
Prefix:MR
First Name:XAVIER
Middle Name:DEWAYNE
Last Name:IRVING
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4612 N 54TH CIR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104-2233
Mailing Address - Country:US
Mailing Address - Phone:402-618-4535
Mailing Address - Fax:
Practice Address - Street 1:4612 N 54TH CIR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68104-2233
Practice Address - Country:US
Practice Address - Phone:402-618-4535
Practice Address - Fax:402-618-4535
Is Sole Proprietor?:No
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide