Individual
CARMEN INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
5001 HARDY ST, HATTIESBURG, MS 39402-1308
(601) 268-8130
Mailing address
5001 HARDY ST, HATTIESBURG, MS 39402-1308
(601) 268-8130
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R865080
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01870054
—
MS
Enumeration date
05/31/2006
Last updated
10/20/2020
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