Provider Demographics
NPI:1700759222
Name:INGEBRIGTSEN, CYRESE
Entity type:Individual
Prefix:
First Name:CYRESE
Middle Name:
Last Name:INGEBRIGTSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1472 OAKDALE AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ST PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55118-3212
Mailing Address - Country:US
Mailing Address - Phone:320-304-1918
Mailing Address - Fax:
Practice Address - Street 1:1472 OAKDALE AVE
Practice Address - Street 2:
Practice Address - City:WEST ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55118-3212
Practice Address - Country:US
Practice Address - Phone:320-304-1918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNDOUL-265374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula