Healthcare Provider Details

I. General information

NPI: 1356477319
Provider Name (Legal Business Name): ISU THIELEN STUDENT HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 07/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2260 THIELEN STUDENT HEALTH CENTER UNION & SHELDON DRIVE
AMES IA
50011-0001
US

IV. Provider business mailing address

2260 THIELEN STUDENT HEALTH CENTER UNION & SHELDON DRIVE
AMES IA
50011-0001
US

V. Phone/Fax

Practice location:
  • Phone: 515-294-7960
  • Fax: 515-294-5457
Mailing address:
  • Phone: 515-294-7960
  • Fax: 515-294-5457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number StateIA

VIII. Authorized Official

Name: LISA RAMSEY
Title or Position: BUSINESS MANAGER
Credential:
Phone: 515-294-7960