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ANITRA LESHAUN INGRAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
PO BOX 62734, COLORADO SPRINGS, CO 80962-2734
(719) 285-7105
Mailing address
PO BOX 62734, COLORADO SPRINGS, CO 80962-2734

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.1617440
CO
363LF0000X
Family Nurse Practitioner
Primary
APN.0999707-NP
CO

Other

Enumeration date
11/02/2012
Last updated
05/08/2024
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