MS. INGRID LARGE EDSTROM BSN CFNP MED NPI 1689630410

NPI Information

NPI: 1689630410
Provider Name: MS. INGRID LARGE EDSTROM, BSN CFNP MED
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
315 GOODPASTURE ISLAND RD
EUGENE, OR
ZIP 97401
Phone: (541) 302-2977
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MS. Ingrid Large Edstrom, BSN CFNP MED is a family nurse practitioner in Eugene, OR with 50 years of experience. MS. Ingrid Large Edstrom, BSN CFNP MED NPI is 1689630410. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

315 GOODPASTURE ISLAND RD
EUGENE, OR
ZIP 97401-109
Phone: (541) 302-2977
Fax: (541) 302-6565

The NPI 1689630410 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/21/2006 and was last updated on 7/16/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	200550045NPPP	OREGON	Yes
2	363LF0000X	Nurse Practitioner	Family	1113222	MASSACHUSETTS	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	269858	MEDICAID	OREGON
2	200550045NPPP	OTHER		OR FNP#
3	NP2194	OTHER	OREGON	BCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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