Individual
DONECIA INGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5796 KEYSTONE GRV, LITHONIA, GA 30058-5692
(678) 849-9088
Mailing address
5796 KEYSTONE GRV, LITHONIA, GA 30058-5692
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
280726
GA
Other
Enumeration date
06/25/2024
Last updated
01/08/2026
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