Provider Demographics
NPI:1326844457
Name:WILEY, JASON
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:WILEY
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:PO BOX 486
Mailing Address - Street 2:
Mailing Address - City:WESTERN
Mailing Address - State:NE
Mailing Address - Zip Code:68464-0486
Mailing Address - Country:US
Mailing Address - Phone:402-432-6505
Mailing Address - Fax:
Practice Address - Street 1:210 W SYCAMORE
Practice Address - Street 2:
Practice Address - City:WESTERN
Practice Address - State:NE
Practice Address - Zip Code:68464-2298
Practice Address - Country:US
Practice Address - Phone:402-432-6505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care