Healthcare Provider Details

I. General information

NPI: 1629982590
Provider Name (Legal Business Name): MANDAN PUBLIC SCHOOL DISTRICT 1
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 DIVISION ST NW
MANDAN ND
58554-1641
US

IV. Provider business mailing address

901 DIVISION ST NW
MANDAN ND
58554-1641
US

V. Phone/Fax

Practice location:
  • Phone: 701-751-6500
  • Fax: 701-751-6688
Mailing address:
  • Phone: 701-751-6500
  • Fax: 701-751-6688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number StateNULL

VIII. Authorized Official

Name: RYAN LAGASSE
Title or Position: BUSINESS MANAGER
Credential:
Phone: 701-751-6500