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General NPI Number Information
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NPI Number | 1174745327
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Entity Type | Organization
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Legal Business Name | EDDYVILLE BLAKESBURG CSD
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 407 WILSON
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City | BLAKESBURG
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State | IA
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Zip | 52553
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Country | US
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Telephone | 641-938-2202
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Fax | 641-938-2613
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Provider Business Mailing Address
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Address Line | 407 WILSON
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City | BLAKESBURG
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State | IA
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Zip | 52553
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Country | US
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Telephone | 641-938-2202
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Fax | 641-938-2613
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Authorized Official
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Title or Position | DISTRICT NURSE
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Name | MS. AMANDA CATHERINE HERRMANN
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Credential | RN,BSN
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Telephone | 641-777-1200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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