Individual
DR. OCTAVIA INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, FNP-C, PMHNP-BC
Contact information
Practice address
13729 TAB DR, NORTHPORT, AL 35475-1694
(929) 949-3134
(929) 929-1476
Mailing address
13729 TAB DR, NORTHPORT, AL 35475-1694
(662) 312-2258
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
1-142018
AL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
403475
NY
Other
Enumeration date
09/06/2018
Last updated
08/16/2022
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