Individual
KACEY INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
985 TAYLOR ST SW, CONYERS, GA 30012-5357
(770) 785-4345
Mailing address
2570 RIVERSIDE PKWY, LAWRENCEVILLE, GA 30046-3339
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN711984
GA
Other
Enumeration date
04/22/2026
Last updated
04/22/2026
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