Provider Demographics
NPI:1720132426
Name:RAIRIGH, JASON ROBERT (RN)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:ROBERT
Last Name:RAIRIGH
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:JASON
Other - Middle Name:ROBERT
Other - Last Name:RAIRIGH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:80567 COUNTY ROAD 15
Mailing Address - Street 2:
Mailing Address - City:MITCHELL
Mailing Address - State:NE
Mailing Address - Zip Code:69357-2129
Mailing Address - Country:US
Mailing Address - Phone:308-614-2464
Mailing Address - Fax:
Practice Address - Street 1:4110 AVENUE D
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-4650
Practice Address - Country:US
Practice Address - Phone:308-635-3171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE51856163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health