=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770382152
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JANE SHERYL YOUNG
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/10/2025
-----------------------------------------------------
Last Update Date | 03/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 505 S 10TH ST
-----------------------------------------------------
City | WYMORE
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68466-2141
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-239-7265
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 505 S 10TH ST # NE68466
-----------------------------------------------------
City | WYMORE
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68466-2141
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-239-7265
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 251E00000X
-----------------------------------------------------
License Number State | NE
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number | 251E00000X
-----------------------------------------------------
License Number State | NE
-----------------------------------------------------