Individual
MRS. KOURTNEY INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
4501 RUSSELL PKWY STE 31, WARNER ROBINS, GA 31088-8681
(478) 403-3295
Mailing address
520 GA HIGHWAY 247 S # 160, BONAIRE, GA 31005-3886
(478) 403-3295
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN266250
GA
363LA2100X
Acute Care Nurse Practitioner
RN266250
GA
363LA2200X
Adult Health Nurse Practitioner
Primary
RN266250
GA
363LG0600X
Gerontology Nurse Practitioner
RN266250
GA
Other
Enumeration date
08/10/2021
Last updated
12/11/2025
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