Healthcare Provider Details

I. General information

NPI: 1477732907
Provider Name (Legal Business Name): KAUKAUNA AREA SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2007
Last Update Date: 11/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 SULLIVAN AVE
KAUKAUNA WI
54130-3564
US

IV. Provider business mailing address

112 MAIN AVE
KAUKAUNA WI
54130-2437
US

V. Phone/Fax

Practice location:
  • Phone: 920-766-6116
  • Fax: 920-766-6122
Mailing address:
  • Phone: 920-766-6100
  • Fax: 920-766-6104

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: MR. RANDY HUGHES
Title or Position: DIRECTOR OF SPECIAL EDUCATION
Credential:
Phone: 920-766-6116