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General NPI Number Information
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NPI Number | 1295726859
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Entity Type | Individual
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Provider Name | LAURA MICHELLE INGRUM NP-C
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Gender | Female
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Dates
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Enumeration Date | 11/02/2005
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | M/MED/QI, SA-1 US DEPARTMENT OF STATE
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City | WASHINGTON
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State | DC
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Zip | 20522-0102
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Country | US
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Telephone | 202-663-1519
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Fax | 260-496-8077
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Provider Business Mailing Address
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Address Line | M/MED/QI, SA-1 US DEPARTMENT OF STATE
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City | WASHINGTON
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State | DC
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Zip | 20522-0102
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Country | US
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Telephone | 202-663-1519
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Fax | 260-496-8077
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NP500011974
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License Number State | DC
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