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General NPI Number Information
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NPI Number | 1194282285
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF NORTH CAROLINA AT PEMBROKE STUDENT HEALTH SERVICES
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Dates
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Enumeration Date | 02/25/2019
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 113 HAWK DRIVE
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City | PEMBROKE
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State | NC
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Zip | 28372
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Country | US
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Telephone | 910-521-6219
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Fax | 910-521-6549
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Provider Business Mailing Address
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Address Line | PO BOX 1510, UNC PEMBROKE STUDENT HEALTH SERVICES
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City | PEMBROKE
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State | NC
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Zip | 28372-1510
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Country | US
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Telephone | 910-521-6219
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Fax | 910-521-6549
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Authorized Official
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Title or Position | VICE CHANCELLOR FOR STUDENT AFFAIRS
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Name | DR. JEFFERY HOWARD
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Credential | E.D.D
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Telephone | 910-521-6175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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