Individual
MALINDA INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1041 S MADISON ST, TUPELO, MS 38801-6391
(662) 844-8754
(628) 448-7416
Mailing address
1041 S MADISON ST, TUPELO, MS 38801-6391
(662) 844-8754
(662) 844-8741
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
363L00000X
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00120516
—
MS
01
—
363L00000X
TAXONOMY
MS
Enumeration date
06/21/2006
Last updated
02/14/2025
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