Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | NP-08936 | OH |
NPI | 1013130996 |
---|---|
Provider Name | Jeanne L Ingles |
First Address | Gallipolis, OH 45631-1803 |
Second Address | Gallipolis, OH 45631-1803 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2007 |
Last Update Date | 01/10/2009 |