Individual
TRACY LEA INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P., R.N.
Contact information
Practice address
718 N LINCOLN ST, GREENSBURG, IN 47240-1348
(812) 662-0588
(812) 663-5932
Mailing address
3306 N COUNTY ROAD 420 W, GREENSBURG, IN 47240-7793
(812) 663-7596
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71001970A
IN
363LF0000X
Family Nurse Practitioner
71001970A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200537070
—
IN
Enumeration date
09/08/2005
Last updated
06/16/2008
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