Search › Arizona › 172V00000X
Jaime Ingram
NPI 1306551122 · on the registry since 2023
Practice
- Address
- 25062 S 190th St
Queen Creek, AZ 85142 - Phone
- (480) 329-0707
- Organisation at this address
- Fortitude 611 Llc
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 172V00000X
172V00000X
- Also registered as
- 171400000X
- Licence states on file
- AZ
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2023-04-26
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Arizona