Marquasia Abrianna Ingram, CN0030088809
Individual provider Active NPI Nurse's Aide · Auburn, GA
NPI 1962269035 · NPPES record last updated Mar 5, 2024
Key facts
- NPI
- 1962269035
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse's Aide 376K00000X
- License
- CN0030088809 (GA)
- Practice address
- 4869 Lily Stem Dr
Auburn, GA 30011-2144 - Phone
- (678) 907-4017
- NPI assigned
- Mar 5, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CN0030088809 | GA | MD | Nurse's Aide |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | CN0030088809 | GA | Yes |
Addresses
Primary practice location
4869 Lily Stem Dr
Auburn, GA 30011-2144
Mailing address
4869 Lily Stem Dr
Auburn, GA 30011-2144
Phone (678) 907-4017
Other providers in Auburn, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.