Stephenie Renee Ingram, CNP-Family
Nurse Practitioner in Wilburton, OK. Individual provider (NPI-1).
NPI number1407129372
StatusActive
Last updated in NPPESJan 10, 2024
Details
- NPI
- 1407129372
- Entity type
- Individual (NPI-1)
- Name
- Stephenie Renee Ingram
- Credential
- CNP-Family
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 22, 2012
- Certification date
- Jan 10, 2024
- Last updated
- Jan 10, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 72256 | OK | Yes |
| 363LF0000X | Nurse Practitioner, Family | 72256 | OK |
Practice location
210 W Main StWilburton, OK 74578-4046
Phone 918-465-9612 · Fax 918-465-9613
Mailing address
210 W Main StWilburton, OK 74578-4046
Phone 918-465-9612 · Fax 918-465-9613
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