Individual
JASON KYLE FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
104 S SCHILLER AVE, WALLACE, NE 69169
(720) 345-4876
Mailing address
1101 HALLIGAN DR, NORTH PLATTE, NE 69101-7659
(720) 345-4876
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
H14172980
NE
Other
Enumeration date
09/16/2025
Last updated
09/16/2025
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