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NPI Code Detail

MEDICARE: DR. KRISTIN LAUREN INGRAM DNP

MEDICARE: DR. KRISTIN LAUREN INGRAM DNP
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
1363LF0000XFamily Nurse Practitioner9364CT

General Provider Information

NPI Number : 1932703410
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KRISTIN LAUREN INGRAM DNP
Provider Business Mailing Address
First Line : 1290 SILAS DEANE HWY
Second Line :
City : WETHERSFIELD
State : CT
Zip : 06109-4337
Country : US
Telephone Number : 434-249-5417
Fax Number :
Provider Business Practice Location Address
First Line : 339 W MAIN ST
Second Line :
City : AVON
State : CT
Zip : 06001-4322
Country : US
Telephone Number : 860-696-2150
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/25/2020
Last Update Date : 03/20/2026

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