Provider Demographics
NPI:1568507002
Name:ISAAC SCHOOLS DISTRICT #5
Entity Type:Organization
Organization Name:ISAAC SCHOOLS DISTRICT #5
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:CALLESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-455-6805
Mailing Address - Street 1:2425 W CITRUS WAY
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-1812
Mailing Address - Country:US
Mailing Address - Phone:602-446-7993
Mailing Address - Fax:
Practice Address - Street 1:3402 W MCDOWELL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85009-2317
Practice Address - Country:US
Practice Address - Phone:602-455-6805
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPO31624390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty