1164165544 NPI number — COUNTY OF NUCKOLLS SCHOOL DISTRICT NO. 11

Table of content: (NPI 1164165544)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164165544 NPI number — COUNTY OF NUCKOLLS SCHOOL DISTRICT NO. 11

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF NUCKOLLS SCHOOL DISTRICT NO. 11
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164165544
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/14/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 288
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SUPERIOR
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68978-0288
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-879-3257
Provider Business Mailing Address Fax Number:
855-529-4534

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
601 W 8TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUPERIOR
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68978-1457
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-879-3257
Provider Business Practice Location Address Fax Number:
855-529-4534
Provider Enumeration Date:
04/14/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WILLIAMS
Authorized Official First Name:
KIMBERLY
Authorized Official Middle Name:
B
Authorized Official Title or Position:
BUSINESS MANAGER
Authorized Official Telephone Number:
402-879-3257

Provider Taxonomy Codes

  • Taxonomy code: 251300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)