Wildgrove, Jay

Wildgrove, Jay is an individual health care provider with primary practice located at 3500 Lakeside Ct Ste 145 , Reno NV 89509-4866. He recently has only one registered license in Nursing Service Related Providers / Personal Care Attendant, which is considered as his primary health care specialty. Wildgrove, Jay can be contacted via phone (775) 359-7272.

Contact Information

Primary practice address
3500 Lakeside Ct Ste 145 Reno NV 89509-4866
Phone: (775) 359-7272
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Personal Care Attendant 3747P1801X

Profile Details

NPI number 1659917607
LBN Legal business name Wildgrove, Jay
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 25th, 2019
Last updated Nov 25th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659917607 NPPES
Nevada MEDICAID 1306115449

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