Individual
JAYNA INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12730 LAKE CONROE HILLS DR, WILLIS, TX 77318-5332
(903) 820-9864
Mailing address
12730 LAKE CONROE HILLS DR, WILLIS, TX 77318-5332
(903) 820-9864
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
347202
TX
Other
Enumeration date
04/11/2019
Last updated
04/11/2019
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