Healthcare Provider Details

I. General information

NPI: 1073792750
Provider Name (Legal Business Name): JULIA INGWERSON A.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2007
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 S GRAND AVE
SAINT MARYS KS
66536-1637
US

IV. Provider business mailing address

206 S GRAND AVE
SAINT MARYS KS
66536-1637
US

V. Phone/Fax

Practice location:
  • Phone: 785-437-3734
  • Fax: 785-437-6186
Mailing address:
  • Phone: 785-437-3734
  • Fax: 785-437-6186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number45891
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number53-45891
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: