Organization Name: | GUSTAVUS ADOLPHUS COLLEGE |
NPI Number: | 1508911330 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KENNETH C WESTPHAL (VP FOR FINANCE) |
Mailing Address: | 800 W College Ave Health Service Saint Peter |
State: | MN US |
Postal Code: | 560821485 |
Phone Number: | 5079338000 |
Fax Number: | 5079336074 |
NPI Enumeration Date: | 01/24/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R0914222 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | MN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |