Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Jay Russell Waite, IDC

Individual provider Independent Duty Corpsman · NPI 1114064789

Mr. Jay Russell Waite, IDC is an Independent Duty Corpsman in Fallon, Nevada. Registered with an NPI since 2007.

In the registry since
2007

Practice location Address checks out

4755 Pasture Rd
Fallon, NV 89496-5000
Phone: (775) 426-3130
Fax: (775) 426-3133
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Independent Duty Corpsman (primary) Taxonomy 1710I1002X

Record details

NPI number1114064789
Entity typeIndividual (Type 1)
GenderMale
Credentials IDC
Sole proprietorNo
NPI enumeratedJanuary 31, 2007
Last updated in NPPESJuly 8, 2007

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