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NPI Code Detail

MEDICARE: CINDY LEE INGRAM C.R.N.A.

MEDICARE: CINDY LEE INGRAM C.R.N.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse AnesthetistNA-08616OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2311072406OTHEROH3RD PARTY PAYERS

General Provider Information

NPI Number : 1225173313
Entity Type Code : Individual
Provider Name (Legal Business Name) : CINDY LEE INGRAM C.R.N.A.
Provider Business Mailing Address
First Line : 272 HOSPITAL RD
Second Line :
City : CHILLICOTHEE
State : OH
Zip : 45601-9031
Country : US
Telephone Number : 740-779-7540
Fax Number : 740-779-7867
Provider Business Practice Location Address
First Line : 100 DAWN LN
Second Line :
City : WAVERLY
State : OH
Zip : 45690-9138
Country : US
Telephone Number : 740-947-6391
Fax Number : 740-947-6538
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2007
Last Update Date : 12/28/2020

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