| Doctor Name: | INGRID LUNDGREN |
| NPI Number: | 1023212446 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | PA002170 |
| Business Practice Address: | 2100 Dixon St Des Moines, IA - 503162174 |
| Business Phone Number: | 5152651020 |
| Business Fax Number: | |
| Mailing Address: | 2100 Dixon St, DES MOINES |
| State: | IA |
| Postal Code: | 503162174 |
| Phone Number: | 5152651020 |
| Fax Number: | |
| NPI Enumeration Date: | 06/11/2007 |
| NPI Last Update Date: | 01/04/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA002170 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |