MEDICARE: NUMA TMS LLC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1760375430
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NUMA TMS LLC

Provider Business Mailing Address
First Line	:	98-1247 KAAHUMANU ST STE 106
Second Line	:
City	:	AIEA
State	:	HI
Zip	:	96701-5310
Country	:	US
Telephone Number	:	808-583-6411
Fax Number	:	808-480-7589

Provider Business Practice Location Address
First Line	:	10120 S EASTERN AVE STE 130
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-3953
Country	:	US
Telephone Number	:	702-760-1975
Fax Number	:	808-480-7589

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TRACY L INGRAM
Credential	:	DNP, APRN, PMHNP-BC
Telephone Number	:	808-391-5225

Provider Enumeration Date	:	06/02/2025
Last Update Date	:	06/02/2025

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Directions to “NUMA TMS LLC ” Practice Location

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