Purdue University
Organization Active NPI Student Health Clinic/Center · West Lafayette, IN
NPI 1346239696 · NPPES record last updated Jul 31, 2008
Key facts
- NPI
- 1346239696
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Student Health Clinic/Center 261QS1000X
- Legal business name
- PURDUE UNIVERSITY
- Practice address
- 601 Stadium Mall Dr
West Lafayette, IN 47907-2052 - Phone
- (765) 494-1700
- Fax
- (765) 496-1227
- NPI assigned
- Oct 19, 2005
- Organization subpart
- Yes
- Parent organization (as reported)
- PURDUE UNIVERSITY
Authorized official
- Name
- Ms. Joan M Vaughan
- Title
- Director Hipaa Privacy Compliance
- Phone
- (765) 496-1927
Corporate family (same tax ID) 18
Practitioners 42
-
Amy R Aeschliman, FNP-C
-
Abidemi Mary Ajuwon, APRN, CNS
-
Erin Leigh Bertrand, APRN
-
Sandra Kay Bushman, CFNP
-
Diarmuid Christie, ATC, LAT
-
Jennifer Ann Coddington, DNP, MSN, RN, CPNP
-
Qinglan Ding, MBBS, PHD, AGACNP-BC
-
Amy Jene Ellingwood, ANP
-
Benjamin John Ema, FNP-C
-
Yolanda Y Gonzalez, RNC NP
-
Anne Marie Gritt, M.S., CCC-SLP
-
Kayla Jealea Hamstra, CPNP
-
Jillian Hubertz, AUD
-
Lydia R Kruse, MS, CCC-SLP
-
Julie A Langston, WHNP
-
Danielle C Leaf, NP
-
Paul-Michael Christian Linville, DNP, FNP-BC
-
Alice S Lusk, MD
-
Christi M Masters, MS CCC SLP
-
Jessica Marie Monjaras, FNP-BC, FNP-C
-
Sarah Jo Myers, NP
-
Huey Mei NG, PH.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 15D0701130 | Purdue University Student Health | Provider-performed microscopy | Oct 29, 2027 |
National Provider Directory
- Tax ID family
- Purdue University Sports Medicine West Lafayette
- Part of
- Purdue University Sports Medicine West Lafayette
Locations
425 E 5th St
Ste B
Burlington, IN 46915
Phone (765) 566-5055
355 N Martin Jischke Dr
West Lafayette, IN 47907
Phone (765) 494-1839
601 Stadium Mall Dr
Ste 2
West Lafayette, IN 47907
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student Health Clinic/Center | 261QS1000X | Yes |
Addresses
Primary practice location
601 Stadium Mall Dr
West Lafayette, IN 47907-2052
Mailing address
601 Stadium Mall Dr
West Lafayette, IN 47907-2052
Phone (765) 494-1700
Other names
- Purdue University Student Health Center
Other providers in West Lafayette, IN
- Elizabeth Marie Pritchett
- Kyla Pruzin
- Purdue GMP Center
- Purdue Sports Medicine WL
- Purdue University
- Purdue University
- Purdue University
- Purdue University Sports Medicine West Lafayette
- Ravindra Putta
- Whitney Queen
All providers in West Lafayette, IN · Student Health Clinic/Center in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.