Provider Demographics
NPI:1578629747
Name:PERRY COMMUNITY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:PERRY COMMUNITY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:J
Authorized Official - Last Name:LANSING
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:515-465-8460
Mailing Address - Street 1:1200 18TH ST
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:IA
Mailing Address - Zip Code:50220-2311
Mailing Address - Country:US
Mailing Address - Phone:515-465-8460
Mailing Address - Fax:515-465-5977
Practice Address - Street 1:1200 18TH ST
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:IA
Practice Address - Zip Code:50220-2311
Practice Address - Country:US
Practice Address - Phone:515-465-8460
Practice Address - Fax:515-465-5977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0262451Medicaid