Healthcare Provider Details

I. General information

NPI: 1992879845
Provider Name (Legal Business Name): UNIVERSITY OF LOUISIANA AT MONROE STUDENT HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 UNIVERSITY AVE
MONROE LA
71209-0001
US

IV. Provider business mailing address

1140 UNIVERSITY AVENUE
MONROE LA
71209-1170
US

V. Phone/Fax

Practice location:
  • Phone: 318-342-1651
  • Fax: 318-342-3280
Mailing address:
  • Phone: 318-342-1651
  • Fax: 318-342-3280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WC1400X
TaxonomyCollege Health Registered Nurse
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. JAN CORDER
Title or Position: DEAN, COLLEGE OF HEALTH SCIENCES
Credential: D.S.N., R.N.
Phone: 318-342-1624