Individual
JESSICA A. INGRAM
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MNT
Contact information
Practice address
1 PENN BLVD., SUITE 2240, PHILADELPHIA, PA 19144
(215) 991-9440
(215) 849-2975
Mailing address
1 PENN BLVD., SUITE 2240, PHILADELPHIA, PA 19144
(215) 991-9440
(215) 849-2975
Taxonomy
Speciality
Code
Description
License number
State
133VN1005X
Renal Nutrition Registered Dietitian
Primary
DN000551
PA
Other
Enumeration date
02/13/2006
Last updated
07/08/2007
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