Healthcare Provider Details

I. General information

NPI: 1023747979
Provider Name (Legal Business Name): LITCHFIELD PUBLIC SCHOOL DIST. 15
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2022
Last Update Date: 06/07/2022
Certification Date: 05/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N MAIN ST
LITCHFIELD NE
68852-0167
US

IV. Provider business mailing address

PO BOX 167
LITCHFIELD NE
68852-0167
US

V. Phone/Fax

Practice location:
  • Phone: 308-446-2244
  • Fax: 308-446-2244
Mailing address:
  • Phone: 308-446-2244
  • Fax: 308-446-2244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. TASHA FLETCHER
Title or Position: BUSINESS MANAGER
Credential:
Phone: 308-446-2244