Individual
JAY HOWARD GUSTAFSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
87765 WILLOW RIDGE LN, LONG PINE, NE 69217-5287
(402) 760-1078
Mailing address
PO BOX 351, AINSWORTH, NE 69210-0351
(402) 760-1078
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
03/20/2026
Last updated
03/20/2026
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