MRS. MARY ANN CUSTER FNP NPI 1891972865

NPI Information

NPI: 1891972865
Provider Name: MRS. MARY ANN CUSTER, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
18040 SW LOWER BOONES FERRY RD
SUITE 100
TIGARD, OR
ZIP 97224
Phone: (503) 216-0700
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MRS. Mary Ann Custer, FNP is a family nurse practitioner in Tigard, OR. MRS. Mary Ann Custer, FNP NPI is 1891972865. 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:

18040 SW LOWER BOONES FERRY RD
SUITE 100
TIGARD, OR
ZIP 97224-258
Phone: (503) 216-0700

The enumeration date for this NPI number is 1/22/2008 and was last updated on 10/28/2012.

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	200850006NP	OREGON	Yes

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	R157298	MEDICARE PIN	OREGON
2	218626	MEDICAID	OREGON
3	R146642	MEDICARE PIN	OREGON
4	R143492	MEDICARE PIN	OREGON
5	R157299	MEDICARE PIN	OREGON
6	P00650720	OTHER	OREGON	RR MEDICARE
7	R143601	MEDICARE PIN	OREGON

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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