Individual provider · Type 1 NPI
Ingrid Large Edstrom, BSN CFNP MED
Family Nurse Practitioner · Eugene, OR
NPI number
1689630410
Active
Practice location
315 Goodpasture Island Rd
Eugene, OR 97401-2109
Fax (541) 302-6565
Mailing address
1102 Hodson Ln
Eugene, OR 97404-2944
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1113222 (MA) |
| Family Nurse Practitioner Primary | 363LF0000X | 200550045NPPP (OR) |
Family Nurse Practitioner: Definition to come...
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About NPI 1689630410
Ingrid Large Edstrom, BSN CFNP MED's National Provider Identifier is 1689630410, issued on Apr 21, 2006. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Eugene, OR. The record was last updated on Jul 16, 2021.