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General NPI Number Information
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NPI Number | 1386566297
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Entity Type | Individual
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Provider Name | TYRONIQUE INGRAM FNP, CNM
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Gender | Female
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Dates
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Enumeration Date | 07/30/2026
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Last Update Date | 07/30/2026
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Provider Practice Location Address
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Address Line | 16777 MEDICAL CENTER DR
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City | BATON ROUGE
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State | LA
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Zip | 70816-3228
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Country | US
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Telephone | 225-761-5200
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Fax |
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Provider Business Mailing Address
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Address Line | 1009 CHERIE LN
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City | SLIDELL
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State | LA
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Zip | 70460-3988
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Country | US
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Telephone | 504-939-3450
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Fax |
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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 | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 206496
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 206496
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License Number State | LA
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