Active NPI
Ingrid Estephan, AGACNP-BC
- Nurse Practitioner
- Minneapolis, MN
National Provider Identifier
1831646108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 041461373
- Practice address
- 2929 21St Ave S Apt 301
Minneapolis, MN 55407-4515 - Phone
- (320) 250-3019
- NPI assigned
- Sep 5, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | CNP 4517 | MN | |
| Adult Health Nurse Practitioner | 363LA2200X | CNP 4517 | MN | |
| Gerontology Nurse Practitioner | 363LG0600X | CNP 4517 | MN | |
| Nurse Practitioner | 363L00000X | 041461373 | IL | Primary |
Addresses
Primary practice location
2929 21St Ave S Apt 301
Minneapolis, MN 55407-4515
Mailing address
148 Timber CT
Wood Dale, IL 60191-1356
Phone (877) 219-6822
Other practice location 1
420 S. Schmidt Rd
Bolingbrook, IL 60440
Phone (630) 312-4562
Other practice location 2
120 S 6th St
Minneapolis, MN 55402-1803
Phone (612) 873-5955
Other practice location 3
148 Timber Ct
Wood Dale, IL 60191-1356
Phone (877) 219-6822 ext. 402
Other practice location 4
148 Timber Ct
Wood Dale, IL 60191
Phone (320) 250-3019
Other practice location 5
148 Timber Ct
Wood Dale, IL 60191-1356
Phone (800) 441-3667
Other practice location 6
2929 21st Ave S Apt 301
Minneapolis, MN 55407-4515
Phone (320) 250-3019
Other practice location 7
2929 21st Ave S Apt 301
Minneapolis, MN 55407-4515
Phone (320) 250-3019
Other practice location 8
148 Timber Ct
Wood Dale, IL 60191
Phone (320) 250-3019
Other names 1
- Ingrid Miller
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CNP 4517 | MN | MD | Gerontology Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556064000000",
"number": "1831646108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "148 TIMBER CT",
"city": "WOOD DALE",
"state": "IL",
"postal_code": "601911356",
"telephone_number": "877-219-6822",
"fax_number": "877-219-6822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2929 21ST AVE S APT 301",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554074515",
"telephone_number": "320-250-3019"
}
],
"practiceLocations": [
{
"address_1": "420 S. Schmidt Rd",
"address_purpose": "LOCATION",
"city": "Bolingbrook",
"state": "IL",
"postal_code": "60440",
"country_code": "US",
"telephone_number": "630-312-4562",
"fax_number": "630-312-6651",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "120 S 6th St",
"address_purpose": "LOCATION",
"city": "Minneapolis",
"state": "MN",
"postal_code": "554021803",
"country_code": "US",
"telephone_number": "612-873-5955",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "148 Timber Ct",
"address_purpose": "LOCATION",
"city": "Wood Dale",
"state": "IL",
"postal_code": "601911356",
"country_code": "US",
"telephone_number": "877-219-6822 x402",
"fax_number": "000-000-0000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "148 Timber Ct",
"address_purpose": "LOCATION",
"city": "Wood Dale",
"state": "IL",
"postal_code": "60191",
"country_code": "US",
"telephone_number": "320-250-3019",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "148 Timber Ct",
"address_purpose": "LOCATION",
"city": "Wood Dale",
"state": "IL",
"postal_code": "601911356",
"country_code": "US",
"telephone_number": "800-441-3667",
"fax_number": "800-441-3667",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2929 21st Ave S Apt 301",
"address_purpose": "LOCATION",
"city": "Minneapolis",
"state": "MN",
"postal_code": "554074515",
"country_code": "US",
"telephone_number": "320-250-3019",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2929 21st Ave S Apt 301",
"address_purpose": "LOCATION",
"city": "Minneapolis",
"state": "MN",
"postal_code": "554074515",
"country_code": "US",
"telephone_number": "320-250-3019",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "148 Timber Ct",
"address_purpose": "LOCATION",
"city": "Wood Dale",
"state": "IL",
"postal_code": "60191",
"country_code": "US",
"telephone_number": "320-250-3019",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ESTEPHAN",
"first_name": "INGRID",
"credential": "AGACNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-05",
"last_updated": "2019-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "MN",
"license": "CNP 4517",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MN",
"license": "CNP 4517",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "MN",
"license": "CNP 4517",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "041461373",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "INGRID",
"last_name": "MILLER",
"credential": "CNP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.