Healthcare Provider Details

I. General information

NPI: 1184357345
Provider Name (Legal Business Name): SCHOOL DIST 595 CO WAYNE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

203 CRAWFORD AVE
WINSIDE NE
68790-5107
US

IV. Provider business mailing address

203 CRAWFORD AVE
WINSIDE NE
68790-5107
US

V. Phone/Fax

Practice location:
  • Phone: 402-286-4466
  • Fax:
Mailing address:
  • Phone: 402-286-4466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: ANDREW OFFNER
Title or Position: SUPERINTENDENT
Credential:
Phone: 402-286-4466