Provider Demographics
NPI:1417124926
Name:MIDDLETON-CROSS PLAINS AREA SCHOOL DISTRICT
Entity Type:Organization
Organization Name:MIDDLETON-CROSS PLAINS AREA SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KUEHN-SCHETTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-829-9054
Mailing Address - Street 1:7106 SOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-3263
Mailing Address - Country:US
Mailing Address - Phone:608-829-9054
Mailing Address - Fax:608-836-1536
Practice Address - Street 1:7106 SOUTH AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:WI
Practice Address - Zip Code:53562-3263
Practice Address - Country:US
Practice Address - Phone:608-829-9054
Practice Address - Fax:608-836-1536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44212000OtherWI MEDICAID AND BADGERCARE PROGRAMS PROVIDER NUMBER