Individual
MRS. ALLYSON MICHELLE INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
462 ELMA G MILES PKWY STE 102A, HINESVILLE, GA 31313-4000
(912) 369-9310
(912) 877-3102
Mailing address
PO BOX K, GOLDSBORO, NC 27533-9710
(919) 580-0004
(919) 580-9099
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
001006436
NC
363A00000X
Physician Assistant
Primary
9473
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-06436
NC MEDICAL LICENSE
NC
Enumeration date
05/13/2016
Last updated
09/10/2021
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