| Organization Name: | ST NORBERT COLLEGE |
| NPI Number: | 1225287691 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DENISE K STROOBANTS (CLINIC PROVIDER CREDENTIALING) |
| Mailing Address: | 100 Grant St De Pere |
| State: | WI US |
| Postal Code: | 541152002 |
| Phone Number: | 9204033266 |
| Fax Number: | |
| NPI Enumeration Date: | 09/10/2008 |
| NPI Last Update Date: | 09/10/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QS1000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Student Health |
| Taxonomy Definition: | |