Provider Demographics
NPI:1326783184
Name:PASSIER, INGRID (FNP)
Entity Type:Individual
Prefix:MRS
First Name:INGRID
Middle Name:
Last Name:PASSIER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:834 S FRONT ST
Mailing Address - Street 2:
Mailing Address - City:CENTRAL POINT
Mailing Address - State:OR
Mailing Address - Zip Code:97502-2726
Mailing Address - Country:US
Mailing Address - Phone:541-664-7400
Mailing Address - Fax:
Practice Address - Street 1:834 S FRONT ST
Practice Address - Street 2:
Practice Address - City:CENTRAL POINT
Practice Address - State:OR
Practice Address - Zip Code:97502-2726
Practice Address - Country:US
Practice Address - Phone:541-664-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200440965RN163WH1000X
OR202210940NP-PP363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163WH1000XNursing Service ProvidersRegistered NurseHospice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MP7440821OtherDEA NUMBER