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General NPI Number Information
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NPI Number | 1366507436
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Entity Type | Organization
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Legal Business Name | WACONIA SCHOOL DISTRICT
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 512 INDUSTRIAL BLVD
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City | WACONIA
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State | MN
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Zip | 55387
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Country | US
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Telephone | 952-368-8810
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Fax | 952-227-5545
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Provider Business Mailing Address
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Address Line | 401 E 4TH ST
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City | CHASKA
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State | MN
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Zip | 55318-2081
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Country | US
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Telephone | 952-368-8810
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Fax | 952-227-5545
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Authorized Official
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Title or Position | SUPERINTENDENT
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Name | JERRY KJERGAARD
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Credential |
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Telephone | 952-442-0600
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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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