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HEIDI INGRAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
13123 E 16TH AVE, AURORA, CO 80045-7106
(720) 777-1234
Mailing address
PO BOX 110429, AURORA, CO 80042-0429

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN9488635
FL
363LP0200X
Pediatric Nurse Practitioner
Primary
0002606
CO
363LP0200X
Pediatric Nurse Practitioner
0992388
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100295000
FL
Enumeration date
01/16/2017
Last updated
03/05/2021
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