Provider Demographics
NPI:1487802427
Name:WISCONSIN SCHOOL FOR THE DEAF
Entity type:Organization
Organization Name:WISCONSIN SCHOOL FOR THE DEAF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:R
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:262-728-7144
Mailing Address - Street 1:309 W WALWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:DELAVAN
Mailing Address - State:WI
Mailing Address - Zip Code:53115-1027
Mailing Address - Country:US
Mailing Address - Phone:262-728-7144
Mailing Address - Fax:262-728-7168
Practice Address - Street 1:309 W WALWORTH AVE
Practice Address - Street 2:
Practice Address - City:DELAVAN
Practice Address - State:WI
Practice Address - Zip Code:53115-1027
Practice Address - Country:US
Practice Address - Phone:262-728-7144
Practice Address - Fax:262-728-7168
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEPARTMENT OF PUBLIC INSTRUCTION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI85790-030251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare