Individual
MS. MARY-ALICE RODSTROM ERNST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.N.P.
Contact information
Practice address
1590 E. 13TH ST, EUGENE, OR 97403-1232
(541) 346-2770
(541) 346-2747
Mailing address
1232 UNIVERSITY OF OREGON, EUGENE, OR 97403-1205
(541) 346-2770
(541) 346-2747
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1119712
KY
163W00000X
Registered Nurse
333339
OH
363LA2200X
Adult Health Nurse Practitioner
10367
OH
363LA2200X
Adult Health Nurse Practitioner
Primary
201050211NP
OR
363LA2200X
Adult Health Nurse Practitioner
333339-COA1
OH
363LF0000X
Family Nurse Practitioner
6004P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000624383
ANTHEM
KY
01
—
000019886Q
HUMANA
KY
Enumeration date
04/01/2009
Last updated
09/29/2014
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