Provider Demographics
NPI:1124848395
Name:WEBER, JAYME (MSN, RN, CNL)
Entity type:Individual
Prefix:
First Name:JAYME
Middle Name:
Last Name:WEBER
Suffix:
Gender:F
Credentials:MSN, RN, CNL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CAMELOT WAY
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-4248
Mailing Address - Country:US
Mailing Address - Phone:308-830-1312
Mailing Address - Fax:
Practice Address - Street 1:2402 UNIVERSITY DR HSEC
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68849-0001
Practice Address - Country:US
Practice Address - Phone:308-865-1606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE73564163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse