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General NPI Number Information
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NPI Number | 1730966623
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Entity Type | Organization
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Legal Business Name | ENTERPRISE ELEMENTARY SCHOOL DISTRICT
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Dates
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Enumeration Date | 09/13/2023
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Last Update Date | 05/20/2024
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Provider Practice Location Address
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Address Line | 1155 MISTLETOE LN
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City | REDDING
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State | CA
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Zip | 96002-0749
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Country | US
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Telephone | 530-224-4226
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Fax | 530-224-4101
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Provider Business Mailing Address
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Address Line | 1155 MISTLETOE LN
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City | REDDING
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State | CA
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Zip | 96002-0749
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Country | US
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Telephone | 530-224-4226
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Fax | 530-224-4101
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Authorized Official
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Title or Position | DISTRICT NURSE
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Name | KELLY PAGAN
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Credential | RN, MSN
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Telephone | 530-224-4226
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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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