Organization
MN STATE COLLEGES AND UNIVERSITIES
Active
Other names
MSU Student Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE CONNOLLY (DIRECTOR)
(507) 389-5689
Entity
Organization
Contact information
Practice address
600 MAYWOOD AVE, 21 CARKOSKI COMMONS, MANKATO, MN 56001-7008
(507) 389-6276
Mailing address
600 MAYWOOD AVE, 21 CARKOSKI COMMONS, MANKATO, MN 56001-7008
(507) 389-6276
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
167195
UCARE
MN
01
—
17278MA
BLUECROSS BLUESHIELD
MN
Enumeration date
12/13/2005
Last updated
08/22/2020
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