Provider Demographics
NPI:1316056310
Name:STRAM-DOLL, INGRID CHRISTINA (MSN, FNP, APRN-BC)
Entity type:Individual
Prefix:
First Name:INGRID
Middle Name:CHRISTINA
Last Name:STRAM-DOLL
Suffix:
Gender:F
Credentials:MSN, FNP, APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 HOSPITAL PKWY
Mailing Address - Street 2:BLDG A
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95119-1103
Mailing Address - Country:US
Mailing Address - Phone:408-972-7171
Mailing Address - Fax:
Practice Address - Street 1:280 HOSPITAL PKWY
Practice Address - Street 2:BLDG A
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95119-1103
Practice Address - Country:US
Practice Address - Phone:408-972-7171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA333221363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAR22675/ZZZ36822ZMedicare UPIN