Individual
BRANDY E. INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
5030 S MILL AVE STE D12, D12, TEMPE, AZ 85282-6849
(480) 894-2823
(480) 756-6663
Mailing address
5030 S MILL AVE STE D12, TEMPE, AZ 85282-6849
(480) 894-2823
(480) 756-6663
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
3713
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1079446
NCCPA
AZ
05
—
356769
—
AZ
Enumeration date
01/25/2008
Last updated
03/07/2023
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