Sueann Ingersoll, PNP, RN, IBCLC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

16217 Issued in CA

Practice address

26800 Crown Valley Pkwy
Mission Viejo, CA 92691-6384

Phone

(949) 362-1380

Fax

(949) 347-1510

NPI assigned

May 12, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1494547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494547200000",
    "number": "1295262806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26800 CROWN VALLEY PKWY",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916384",
            "telephone_number": "949-362-1380",
            "fax_number": "949-347-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26800 CROWN VALLEY PKWY",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916384",
            "telephone_number": "949-362-1380",
            "fax_number": "949-347-1510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGERSOLL",
        "first_name": "SUEANN",
        "credential": "PNP, RN, IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-12",
        "last_updated": "2017-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "16217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Inter City Transportation
• Interventional Neuroradiology, Inc

• Pediatric Nurse Practitioner in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.