Individual
KASEY INGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
510 BUTLER AVE, MARTINSBURG, WV 25405-9990
(304) 263-0811
Mailing address
138 W WING WAY, BOONSBORO, MD 21713-3409
(301) 514-2401
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
R216358
MD
Other
Enumeration date
12/19/2018
Last updated
12/19/2018
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