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Organization
LILLIAN INGRAM
Active
Organization
LILLIAN INGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILLIAN E INGRAM NP (OWNER/OPERATOR)
(608) 217-6108
Entity
Organization
Contact information
Practice address
1211 TECH BLVD STE 105, TAMPA, FL 33619-7846
(813) 999-1516
(813) 336-8384
Mailing address
1211 TECH BLVD STE 105, TAMPA, FL 33619-7846
(813) 999-1516
(813) 336-8384
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
261QP2300X
Primary Care Clinic/Center
—
NULL
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/30/2021
Last updated
02/16/2022
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