Organization
SOUTHERN UNIVERSITY STUDENT HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERRICKA V FIELDS (OFFICE MANAGER)
(225) 771-4770
Entity
Organization
Contact information
Practice address
170 SWAN ST, BATON ROUGE, LA 70813-0001
(225) 771-3324
(225) 771-2349
Mailing address
PO BOX 11794, BATON ROUGE, LA 70813-1794
(225) 771-3324
(225) 771-2349
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1416886
—
LA
05
—
1529338
—
LA
Enumeration date
01/26/2007
Last updated
08/12/2008
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