Individual
MADALYN INGMIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3601 THE VANDERBILT CLINIC, NASHVILLE, TN 37232-8088
(615) 322-3000
Mailing address
3841 GREEN HILLS VILLAGE DR STE 200, NASHVILLE, TN 37215-2691
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1178143
—
363A00000X
Physician Assistant
Primary
5506
TN
363A00000X
Physician Assistant
9113828
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1178143
NATIONAL COMMISSION ON CERTIFIED PHYSICIAN ASSISTANTS
—
01
—
9113828
FLORIDA DEPARTMENT OF HEALTH
FL
Enumeration date
01/15/2021
Last updated
06/21/2023
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