Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | APN0000014241 | TN |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | APN0000014241 | TN |
NPI | 1013242957 |
---|---|
Provider Name | Ms. Jennifer Lynn Ingram |
First Address | Chattanooga, TN 37421-2444 |
Second Address | Chattanooga, TN 37421-2444 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2009 |
Last Update Date | 20/09/2011 |