# STUDENT HEALTH SERVICE UNIVERSITY OF ST. THOMAS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881819886
- **Authorized official:** MS. MADONNA K MC DERMOTT MS, MPA (DIRECTOR STUDENT HEALTH SERVICE)
- **Authorized official phone:** (651) 962-6750

## Contact information

- **Practice address:** 2115 SUMMIT AVE, MAILBOX \#5056, SAINT PAUL, MN 55105-1048
- **Practice address phone:** (651) 962-6750
- **Practice address fax:** (651) 962-6751
- **Mailing address:** 2115 SUMMIT AVE, MAILBOX \#5056, SAINT PAUL, MN 55105-1048
- **Mailing address phone:** (651) 962-6750
- **Mailing address fax:** (651) 962-6751

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QS1000X | Student Health Clinic/Center | MN32783 | MN | Yes |

## Other

- **Enumeration date:** 04/16/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1114057510 | NPI KATE BOOTH, NP | MN |
| 01 | — | 1184740664 | NPI MADONNA MCDERMOTT | MN |
| 01 | — | 1215999081 | NPI DR. MARILEE VOTEL-KVA | MN |
| 01 | — | 1225156227 | NPI GAIL CONZEMIUS | MN |
| 01 | — | 1669443222 | NPI DR. THOMAS THUL | MN |