# PURDUE UNIVERSITY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** IPFW Center for Healthy Living: Campus Clinic and Wellness Programs
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225584295
- **Authorized official:** CREASIE E HILL (HEALTH CLINIC OFFICE MANAGER)
- **Authorized official phone:** (206) 481-6967

## Contact information

- **Practice address:** 2101 E COLISEUM BLVD, WU 234, FORT WAYNE, IN 46805-1445
- **Practice address phone:** (260) 481-0400
- **Mailing address:** 2101 E COLISEUM BLVD, WU 234, FORT WAYNE, IN 46805-1445
- **Mailing address phone:** (260) 481-0400

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LG0600X | Gerontology Nurse Practitioner | 28079817 | IN | Yes |

## Other

- **Enumeration date:** 08/30/2016
- **Last updated:** 08/30/2016