Healthcare Provider Details

I. General information

NPI: 1205902152
Provider Name (Legal Business Name): NEVADA SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6580 HWY 278
WALDO AR
71770
US

IV. Provider business mailing address

6580 HWY 278
WALDO AR
71770
US

V. Phone/Fax

Practice location:
  • Phone: 870-871-2475
  • Fax: 870-871-2419
Mailing address:
  • Phone: 870-871-2475
  • Fax: 870-871-2419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name: LISA LEN BEARD
Title or Position: NURSE
Credential: LPN
Phone: 870-871-2475