| NPI | 1689819773 |
|---|---|
| Doing Business As | INGRID L. EDSTROM, FNP |
| Entity Type | Organization |
| Authorized Contact | INGRID LARGE EDSTROM President/Owner 541-302-2977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner Women's Health (Licence: OR 200550045-NP-PP) |
| Enumeration Date | 2008-12-04 |
| Last Update Date | 2009-05-05 |