Individual
DEANNA ELAINE INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
9900 BREN RD E, MINNETONKA, MN 55343-9664
(800) 328-5979
Mailing address
103 KNOB HILL RD, VALDOSTA, GA 31602-4220
(904) 718-9387
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
9187104
FL
Other
Enumeration date
07/25/2011
Last updated
11/19/2020
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