MEDICARE: NORTH BEND CENTRAL JUNIOR-SENIOR HIGH SCHOOL SCHOOL DISTRICT 95

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1568123164
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH BEND CENTRAL JUNIOR-SENIOR HIGH SCHOOL SCHOOL DISTRICT 95

Provider Business Mailing Address
First Line	:	1320 WALNUT ST
Second Line	:
City	:	NORTH BEND
State	:	NE
Zip	:	68649-5016
Country	:	US
Telephone Number	:	402-652-3268
Fax Number	:	402-652-8348

Provider Business Practice Location Address
First Line	:	1320 WALNUT ST
Second Line	:
City	:	NORTH BEND
State	:	NE
Zip	:	68649-5016
Country	:	US
Telephone Number	:	402-652-3268
Fax Number	:	402-652-8348

Authorized Official
Title or Position	:	DATA STEWARD/SCHOOL NURSE
Name	:	MEGAN BROKAW
Credential	:
Telephone Number	:	402-652-3268

Provider Enumeration Date	:	01/05/2022
Last Update Date	:	01/05/2022

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