Provider Demographics
NPI:1346639408
Name:CORTE SIERRA ELEMENTARY SCHOOL
Entity Type:Organization
Organization Name:CORTE SIERRA ELEMENTARY SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL NURSE
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:S
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:623-547-1018
Mailing Address - Street 1:272 E SAGEBRUSH ST
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-4934
Mailing Address - Country:US
Mailing Address - Phone:623-535-6000
Mailing Address - Fax:
Practice Address - Street 1:3300 N SANTA FE TRL
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-6734
Practice Address - Country:US
Practice Address - Phone:623-547-1018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LITCHFIELD ELEMENTARY SCHOOL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-01-13
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare