Provider Demographics
NPI:1194282285
Name:UNIVERSITY OF NORTH CAROLINA AT PEMBROKE STUDENT HEALTH SERVICES
Entity type:Organization
Organization Name:UNIVERSITY OF NORTH CAROLINA AT PEMBROKE STUDENT HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE CHANCELLOR FOR STUDENT AFFAIRS
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:910-521-6175
Mailing Address - Street 1:PO BOX 1510, UNC PEMBROKE STUDENT HEALTH SERVICES
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372-1510
Mailing Address - Country:US
Mailing Address - Phone:910-521-6219
Mailing Address - Fax:910-521-6549
Practice Address - Street 1:113 HAWK DRIVE
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28372
Practice Address - Country:US
Practice Address - Phone:910-521-6219
Practice Address - Fax:910-521-6549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-25
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty