SELENE INGRAHAM

PROVO, UT
NPI1780577189
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: UT  8513908-4405)
Enumeration Date2025-06-03
Last Update Date2025-06-20
Business Address
SELENE INGRAHAM APRN
1055 N 500 W STE 201 BLDG C
PROVO, UT 84604
Phone number: 801-429-8000
Mailing Address
SELENE INGRAHAM APRN
1055 N 500 W ATTN CREDENTIALING
PROVO, UT 84604
Phone number: 801-354-8225
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