Organization
NORTH DAKOTA STATE UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERI LYNN SHEPHERD (INSURANCE COORDINATOR)
(701) 231-5239
Entity
Organization
Contact information
Practice address
1707 CENTENNIAL BOULEVARD, FARGO, ND 58102
(701) 231-7331
(701) 231-6132
Mailing address
PO BOX 6050 NDSU DEPT. 5150, NDSU STUDENT HEALTH SERVICE, FARGO, ND 58108-6050
(701) 231-7331
(701) 231-6132
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
168
ND
261Q00000X
Clinic/Center
Primary
—
—
291U00000X
Clinical Medical Laboratory
95503681
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13139
—
ND
Enumeration date
09/12/2006
Last updated
10/23/2018
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