Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME106910 | FL |
N | 111NI0900X | Internist | ME106910 | FL |
Y | 207RR0500X | Rheumatology | ME106910 | FL |
NPI | 1124210067 |
---|---|
Provider Name | Stephanie Fernice Ingram |
First Address | Gainesville, FL 32605-4582 |
Second Address | Ocala, FL 34474-3358 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2007 |
Last Update Date | 04/02/2014 |