Individual
MARCIA LYNNE INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
40 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4304
(616) 456-1443
(616) 732-6392
Mailing address
40 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4304
(616) 456-1443
(616) 732-6392
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
4704287466
MI
Other
Enumeration date
06/05/2021
Last updated
06/05/2021
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