Provider Demographics
NPI: | 1003923137 |
---|---|
Name: | LINCOLN PUBLIC SCHOOL |
Entity Type: | Organization |
Organization Name: | LINCOLN PUBLIC SCHOOL |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | ATHLETIC DIRECTOR |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | KAREN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | HAND |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 402-436-1000 |
Mailing Address - Street 1: | 5701 JUDITH DR |
Mailing Address - Street 2: | |
Mailing Address - City: | LINCOLN |
Mailing Address - State: | NE |
Mailing Address - Zip Code: | 68517-9792 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 402-310-7583 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 5801 N 33RD ST |
Practice Address - Street 2: | |
Practice Address - City: | LINCOLN |
Practice Address - State: | NE |
Practice Address - Zip Code: | 68504-4665 |
Practice Address - Country: | US |
Practice Address - Phone: | 402-436-1305 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-08-24 |
Last Update Date: | 2008-08-01 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NE | 310 | 390200000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program | Group - Single Specialty |