MS. INGRID LARGE EDSTROM (NPI# 1689630410) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689630410 |
| Entity Type | Individual |
| Full Name | MS. INGRID LARGE EDSTROM |
| Other Name | INGRID PADBERG |
| Credential | BSN CFNP MED |
| Practice Address |
315 Goodpasture Island Rd Eugene OR 97401-2109 |
| Mailing Address |
1102 Hodson Ln Eugene OR 97404-2944 |
| Practice Telephone | 5413022977 |
| Practice Fax Number | 5413026565 |
| Mailing Telephone | 5413022977 |
| Mailing Fax Number | 5413026565 |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2018-11-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
1113222 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
200550045NPPP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 269858 | 05 | |
| OR | BCBS | NP2194 | 01 |
| OR FNP# | 200550045NPPP | 01 |
| Street Address |
315 GOODPASTURE ISLAND RD |
| City | EUGENE |
| State | OR |
| Zip Code | 97401-2109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427681709 | Sarah Voigt | Counselor | 2149 Centennial Plaza Suite #4, Eugene, OR 97401 | 2020-02-14 |
| 1801426242 | Therapeutic Associates, Inc. | Physical Therapist | 760 Charnelton St., Suite 760, Eugene, OR 97401 | 2020-01-24 |
| 1225676232 | Aaron James Barber | Massage Therapist | 1375 Pearl St, Eugene, Or 97401, Eugene, OR 97401 | 2019-12-20 |
| 1851957047 | Altru Home Care LLC | Nursing Care | 1345 Olive St., Eugene, OR 97401 | 2019-05-14 |
| 1881155208 | Herron Jordanna Spence | Speech-Language Pathologist | 385 West 2nd Ave., Eugene, OR 97401 | 2019-03-28 |
| 1750855094 | Brandon Marshall | Counselor | 1158 High St Ste 202, Eugene, OR 97401 | 2019-01-21 |
| 1881172591 | Kayla Nicole O'brien | Nurse Practitioner | Country Club In Eugene, 520 Country Club Road, Eugene, OR 97401 | 2018-08-03 |
| 1962992180 | Shannon Jensen Smyth | Counselor | Va Eugene Downtown Clinic, 211 E. 7th Ave, Eugene, OR 97401 | 2018-05-14 |
| 1902305956 | Christine Noel Gray | Peer Specialist | 499 W. 4th Ave, Eugene, OR 97401 | 2018-02-06 |
| 1821507344 | Anjuli Chitkara | Psychologist | 1679 Willamette Street, Eugene, OR 97401 | 2017-09-27 |
| Find all providers in zip 97401 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548870306 | Virtual Recovery | Nurse Practitioner | 1038 Heathrow Dr, Eugene, OR 97402-1585 | 2020-08-06 |
| 1881172591 | Kayla Nicole O'brien | Nurse Practitioner | Country Club In Eugene, 520 Country Club Road, Eugene, OR 97401 | 2018-08-03 |
| 1437605813 | Kari Rocco | Nurse Practitioner | 98 E 11th Ave, Eugene, OR 97401-3538 | 2016-08-26 |
| 1295092765 | Betty J Hamill | Nurse Practitioner | 151 W 7th Ave Ste 520, Eugene, OR 97401-2676 | 2012-04-20 |
| 1801164926 | Alba Schultz | Nurse Practitioner | 2846 Willamette St, Eugene, OR 97405 | 2011-12-03 |
| 1144461682 | Diana Lea Lamboy | Nurse Practitioner | 67 W 29th Ave, Eugene, OR 97405-3242 | 2009-03-12 |
| 1295856532 | Harry Ernest Vandervort IIi | Nurse Practitioner | 4000 E 30th Ave, Eugene, OR 97405-0640 | 2007-04-03 |
| 1790843142 | Ruth Alicia Duffield | Nurse Practitioner | 360 S Garden Way Ste 210, Eugene, OR 97401-8186 | 2006-12-05 |
| 1528134681 | Patricia Anne Wyss | Nurse Practitioner | 3579 Franklin Boulevard, Eugene, OR 97403 | 2006-11-28 |
| 1104906981 | Debra Susan Blaker | Nurse Practitioner | 1902 Jefferson St, Suite 2, Eugene, OR 97405-2414 | 2006-10-16 |
| Find all providers in EUGENE | ||||
Please comment or provide details below to improve the information on MS. INGRID LARGE EDSTROM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.