Provider Demographics
NPI:1316745672
Name:HABERER, JAY ROBERT
Entity type:Individual
Prefix:
First Name:JAY
Middle Name:ROBERT
Last Name:HABERER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CROFTON
Mailing Address - State:NE
Mailing Address - Zip Code:68730-3301
Mailing Address - Country:US
Mailing Address - Phone:605-760-1251
Mailing Address - Fax:
Practice Address - Street 1:906 W 2ND ST
Practice Address - Street 2:
Practice Address - City:CROFTON
Practice Address - State:NE
Practice Address - Zip Code:68730-3301
Practice Address - Country:US
Practice Address - Phone:605-760-1251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist