Provider Demographics
NPI:1750014148
Name:COUNTY OF BURT SCHOOL DISTRICT 1
Entity type:Organization
Organization Name:COUNTY OF BURT SCHOOL DISTRICT 1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL NURSE
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BRUMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:402-374-2157
Mailing Address - Street 1:112 N 13TH ST
Mailing Address - Street 2:
Mailing Address - City:TEKAMAH
Mailing Address - State:NE
Mailing Address - Zip Code:68061-1044
Mailing Address - Country:US
Mailing Address - Phone:402-374-2157
Mailing Address - Fax:402-374-2155
Practice Address - Street 1:112 N 13TH ST
Practice Address - Street 2:
Practice Address - City:TEKAMAH
Practice Address - State:NE
Practice Address - Zip Code:68061-1044
Practice Address - Country:US
Practice Address - Phone:402-374-2157
Practice Address - Fax:402-374-2155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WS0200XNursing Service ProvidersRegistered NurseSchoolGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE222966Medicaid