Ingram, Jan M

Ingram, Jan M is an individual health care provider with primary practice located at 4010 Central Ave , St Petersburg FL 33711-1239. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Ingram, Jan M can be contacted via phone (727) 327-7656.

Contact Information

Primary practice address
4010 Central Ave St Petersburg FL 33711-1239
Phone: (727) 327-7656
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 363LP0808X Florida

Profile Details

NPI number 1407975915
LBN Legal business name Ingram, Jan M
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2007
Last updated Oct 3rd, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407975915 NPPES
Florida MEDICAID 762224400

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