Provider Demographics
NPI:1184598336
Name:SWEENEY, JAMIE JAMES
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:JAMES
Last Name:SWEENEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 LAKEVIEW CIR APT 2
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-6036
Mailing Address - Country:US
Mailing Address - Phone:308-390-7202
Mailing Address - Fax:
Practice Address - Street 1:225 N WEBB RD STE 3
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-4041
Practice Address - Country:US
Practice Address - Phone:308-381-2036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion