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NPI Code Detail

MEDICARE: EDWINA INGRAM

MEDICARE: EDWINA INGRAM
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
1164W00000XLicensed Practical NursePN054364OH

General Provider Information

NPI Number : 1174946784
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDWINA INGRAM
Provider Business Mailing Address
First Line : 200 VIKING WAY
Second Line :
City : CINCINNATI
State : OH
Zip : 45246-1138
Country : US
Telephone Number : 513-864-2070
Fax Number :
Provider Business Practice Location Address
First Line : 200 VIKING WAY
Second Line :
City : CINCINNATI
State : OH
Zip : 45246-1138
Country : US
Telephone Number : 513-864-2070
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2014
Last Update Date : 02/03/2014

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Directions to “ EDWINA INGRAM ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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