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General NPI Number Information
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NPI Number | 1285330365
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Entity Type | Organization
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Legal Business Name | FULLERTON PUBLIC SCHOOLS
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Dates
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Enumeration Date | 02/01/2023
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Last Update Date | 02/01/2023
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Provider Practice Location Address
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Address Line | 606 4TH ST
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City | FULLERTON
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State | NE
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Zip | 68638-3176
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Country | US
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Telephone | 308-536-2431
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Fax | 308-536-2432
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Provider Business Mailing Address
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Address Line | 606 4TH ST # 520
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City | FULLERTON
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State | NE
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Zip | 68638-3176
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Country | US
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Telephone | 308-536-2431
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Fax | 308-536-2432
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Authorized Official
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Title or Position | SUPT
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Name | JEFFREY BRIAN ANDERSON
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Credential |
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Telephone | 308-550-0225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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