Jason Kyle Fisher
Home Health Aide in Wallace, NE. Individual provider (NPI-1).
NPI number1104797679
StatusActive
Last updated in NPPESSep 16, 2025
Details
- NPI
- 1104797679
- Entity type
- Individual (NPI-1)
- Name
- Jason Kyle Fisher
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 16, 2025
- Certification date
- Sep 16, 2025
- Last updated
- Sep 16, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 374U00000X | Home Health Aide | H14172980 | NE | Yes |
Practice location
104 S Schiller AveWallace, NE 69169
Phone 720-345-4876
Mailing address
1101 Halligan DrNorth Platte, NE 69101-7659
Phone 720-345-4876
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