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Individual
LAUREN JETON INGRAM
Active
Individual
LAUREN JETON INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
803942
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
330574001
—
TX
05
—
330574002
—
TX
05
—
330574003
—
TX
05
—
330574004
—
TX
01
—
75-0818167-015
TRICARE
TX
01
—
75-0818167-022
TRICARE
TX
01
—
75-0818167-044
TRICARE
TX
01
—
75-0818167-048
TRICARE
TX
01
—
75-1976930-005
TRICARE
TX
01
—
75-2616977-001
TRICARE
TX
01
—
75-2616977-028
TRICARE
TX
01
—
75-261977-002
TRICARE
TX
01
—
8599ND
BCBS
TX
01
—
8810NF
BCBS
TX
01
—
P01290911
RAIL ROAD
TX
01
—
P01291367
RAIL ROAD
TX
Enumeration date
09/10/2013
Last updated
10/31/2015
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