Individual
TYLER ANDREW INGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(844) 222-2881
Mailing address
593 EDDY ST, PROVIDENCE, RI 02903-4923
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN2311360
MA
Other
Enumeration date
04/23/2019
Last updated
04/23/2019
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