Individual
RICHARD TYLER INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
2230 PARK RD STE 105, CHARLOTTE, NC 28203-6664
(980) 221-2689
Mailing address
2230 PARK RD STE 105, CHARLOTTE, NC 28203-6664
(336) 681-5438
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5018684
NC
Other
Enumeration date
09/11/2023
Last updated
09/11/2023
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