Provider Demographics
NPI:1083268429
Name:GRAND ISLAND PUBLIC SCHOOLS
Entity Type:Organization
Organization Name:GRAND ISLAND PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNSSP SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:WETOVICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-385-5900
Mailing Address - Street 1:123 S WEBB RD
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-5110
Mailing Address - Country:US
Mailing Address - Phone:308-385-5900
Mailing Address - Fax:
Practice Address - Street 1:123 S WEBB RD
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-5110
Practice Address - Country:US
Practice Address - Phone:308-385-5900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-24
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty