PHYLLIS ANNETTE INGHAM

PERU, IN
NPI1003328667
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: IN  71009335A)
Additional Taxonomies363LF0000X Nurse Practitioner, Family
(Licence: TX  AP134764)
363L00000X Nurse Practitioner
(Licence: NM  CNP-03521)
Enumeration Date2017-11-03
Last Update Date2025-10-02
Business Address
PHYLLIS ANNETTE INGHAM NP-C
750 N BROADWAY
PERU, IN 46970-1027
Phone number: 260-569-2120
Mailing Address
PHYLLIS ANNETTE INGHAM NP-C
PO BOX 26666 PHS PROVIDER ENROLLMENT
ALBUQUERQUE, NM 87125-6666
Phone number: 505-923-6770
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