MEDICARE: DANIELLE NICOLE 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
1	3747A0650X	Attendant Care Provider		FL

General Provider Information

NPI Number	:	1821949991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE NICOLE INGRAM

Provider Business Mailing Address
First Line	:	12335 30TH ST E
Second Line	:
City	:	PARRISH
State	:	FL
Zip	:	34219-1612
Country	:	US
Telephone Number	:	941-962-5151
Fax Number	:

Provider Business Practice Location Address
First Line	:	12335 30TH ST E
Second Line	:
City	:	PARRISH
State	:	FL
Zip	:	34219-1612
Country	:	US
Telephone Number	:	941-962-5151
Fax Number	:

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

Provider Enumeration Date	:	02/05/2026
Last Update Date	:	02/05/2026

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Directions to “ DANIELLE NICOLE INGRAM ” Practice Location

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