MEDICARE: REBECCA INGALLS CNM, WHNP-BC

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
1	176B00000X	Midwife	089379-23	NH
2	363L00000X	Nurse Practitioner	CNP241362	ME

General Provider Information

NPI Number	:	1114587391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA INGALLS CNM, WHNP-BC

Provider Business Mailing Address
First Line	:	559 PORTSMOUTH AVE
Second Line	:
City	:	GREENLAND
State	:	NH
Zip	:	03840-2251
Country	:	US
Telephone Number	:	603-436-7588
Fax Number	:

Provider Business Practice Location Address
First Line	:	559 PORTSMOUTH AVE
Second Line	:
City	:	GREENLAND
State	:	NH
Zip	:	03840-2251
Country	:	US
Telephone Number	:	603-436-7588
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2019
Last Update Date	:	02/03/2026

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