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General NPI Number Information
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NPI Number | 1699748905
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Entity Type | Individual
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Provider Name | STACY R INGRAM-HANSON NP
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Gender | Female
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Dates
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Enumeration Date | 02/08/2006
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Last Update Date | 09/12/2022
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Provider Practice Location Address
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Address Line | 815 W POYTHRESS ST
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City | HOPEWELL
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State | VA
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Zip | 23860-2532
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Country | US
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Telephone | 804-458-8557
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Fax | 804-541-7113
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Provider Business Mailing Address
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Address Line | 815 W POYTHRESS ST
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City | HOPEWELL
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State | VA
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Zip | 23860-2532
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Country | US
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Telephone | 804-458-8557
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Fax | 804-541-7113
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024164728
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0357112
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License Number State | VA
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