Individual
MARY MI'SHON INGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, NP-BC
Contact information
Practice address
713 20TH ST, COLUMBUS, GA 31904-8920
(706) 660-5080
Mailing address
323 W CHURCH ST, AMERICUS, GA 31709-3510
(229) 815-0270
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
RN274291
GA
Other
Enumeration date
07/28/2023
Last updated
07/28/2023
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