Provider Demographics
NPI:1992879845
Name:UNIVERSITY OF LOUISIANA AT MONROE STUDENT HEALTH SERVICES
Entity type:Organization
Organization Name:UNIVERSITY OF LOUISIANA AT MONROE STUDENT HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DEAN, COLLEGE OF HEALTH SCIENCES
Authorized Official - Prefix:DR
Authorized Official - First Name:JAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CORDER
Authorized Official - Suffix:
Authorized Official - Credentials:DSN, RN
Authorized Official - Phone:318-342-1624
Mailing Address - Street 1:1140 UNIVERSITY AVENUE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71209-1170
Mailing Address - Country:US
Mailing Address - Phone:318-342-1651
Mailing Address - Fax:318-342-3280
Practice Address - Street 1:1140 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71209-0001
Practice Address - Country:US
Practice Address - Phone:318-342-1651
Practice Address - Fax:318-342-3280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered163WA2000XNursing Service ProvidersRegistered NurseAdministratorGroup - Multi-Specialty
Not Answered163WC1400XNursing Service ProvidersRegistered NurseCollege HealthGroup - Multi-Specialty
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Not Answered363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty