Provider Demographics
NPI:1285701227
Name:IND SCHOOL DIST. 203
Entity type:Organization
Organization Name:IND SCHOOL DIST. 203
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-477-3235
Mailing Address - Street 1:9 6TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:HAYFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55940-7804
Mailing Address - Country:US
Mailing Address - Phone:507-477-3235
Mailing Address - Fax:507-477-3230
Practice Address - Street 1:9 6TH AVE SE
Practice Address - Street 2:
Practice Address - City:HAYFIELD
Practice Address - State:MN
Practice Address - Zip Code:55940-7804
Practice Address - Country:US
Practice Address - Phone:507-477-3235
Practice Address - Fax:507-477-3230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1086256163WS0200X
251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251300000XAgenciesLocal Education Agency (LEA)
No163WS0200XNursing Service ProvidersRegistered NurseSchoolGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN926755700Medicare ID - Type UnspecifiedMN HEALTH CARE PROGRAMS