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General NPI Number Information
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NPI Number | 1356644736
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Entity Type | Organization
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Legal Business Name | EAST CAROLINA UNIVERSITY STUDENT HEALTH SERVICES
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Dates
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Enumeration Date | 12/07/2010
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Last Update Date | 12/07/2010
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Provider Practice Location Address
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Address Line | 1001 EAST 5TH STREET
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City | GREENVILLE
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State | NC
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Zip | 27858-4353
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Country | US
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Telephone | 252-737-2581
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 EAST 5TH STREET
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City | GREENVILLE
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State | NC
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Zip | 27858
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Country | US
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Telephone | 252-737-2581
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MS. CAROL LASHAE LOCKE
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Credential | ANP-BC
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Telephone | 252-367-3689
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number | 5004987
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License Number State | NC
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