Healthcare Provider Details

I. General information

NPI: 1255287256
Provider Name (Legal Business Name): MICHAELA ANNE RINGERSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3132 STATE ST STE 110
MEDFORD OR
97504-8688
US

IV. Provider business mailing address

2869 CALDERA LN
MEDFORD OR
97504-5945
US

V. Phone/Fax

Practice location:
  • Phone: 541-500-4989
  • Fax:
Mailing address:
  • Phone: 516-458-3467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number10061999
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: