Healthcare Provider Details

I. General information

NPI: 1295915551
Provider Name (Legal Business Name): NORTHERN OZAUKEE SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2007
Last Update Date: 11/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 HIGHLAND DR
FREDONIA WI
53021-9491
US

IV. Provider business mailing address

401 HIGHLAND DR
FREDONIA WI
53021-9491
US

V. Phone/Fax

Practice location:
  • Phone: 262-692-2464
  • Fax: 262-692-6257
Mailing address:
  • Phone: 262-692-2464
  • Fax: 262-692-6257

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: DR. WILLIAM H. HARBRON
Title or Position: SUPERINTENDENT
Credential: ED.D
Phone: 262-692-2489