MEDICARE: KRISTIN KAY 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	101YA0400X	Addiction (Substance Use Disorder) Counselor	306705	MN

General Provider Information

NPI Number	:	1912772203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIN KAY INGRAM

Provider Business Mailing Address
First Line	:	1702 171ST AVE NE
Second Line	:
City	:	HAM LAKE
State	:	MN
Zip	:	55304-4917
Country	:	US
Telephone Number	:	952-454-3655
Fax Number	:

Provider Business Practice Location Address
First Line	:	1702 171ST AVE NE
Second Line	:
City	:	HAM LAKE
State	:	MN
Zip	:	55304-4917
Country	:	US
Telephone Number	:	952-454-3655
Fax Number	:

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

Provider Enumeration Date	:	11/16/2023
Last Update Date	:	11/16/2023

Similar Medicare Providers

1689675340 — AVALON CARE CENTER-WILLOW WOOD, INC
Practice Location Address:

1205 E 4725 S
SALT LAKE CITY, UT
84117-4917

Practice Phone: 801-262-2908
Practice Fax: 801-262-2963

1215337811 — LEAH MANCINI OTR/L
Practice Location Address:

1205 E 4725 S
SALT LAKE CITY, UT
84117-4917

Practice Phone: 801-262-2908
Practice Fax:

1124591987 — GUNNISON VALLEY HOSPITAL
Practice Location Address:

1205 E 4725 S
SALT LAKE CITY, UT
84117-4917

Practice Phone: 801-262-2908
Practice Fax: 801-262-2963

1518509637 — CONNIE RUSSELL
Practice Location Address:

1205 E BONNER WAY
SALT LAKE CITY, UT
84117-4917

Practice Phone: 801-598-8337
Practice Fax:

1790514933 — KATIE ANN RAMOS
Practice Location Address:

4917 LAKE RIDGE LN
HOLIDAY, FL
34690-5526

Practice Phone: 727-564-2857
Practice Fax:

1841166196 — IYANAH ROZIER
Practice Location Address:

5518 GLEN LAKE LN
ORLANDO, FL
32808-4917

Practice Phone: 407-209-9049
Practice Fax:

Directions to “ KRISTIN KAY 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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.