NPI 1154595676

Stephanie Ingram, CSA

Practitioner Surgical Physician Assistant Conyers, GA

Practice location

Address: 863 Flat Shoals Rd SE STE C238, Conyers, GA 30094-6633
Phone: (770) 354-6940

Registered specialties

Surgical Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AS0400X Licence 3135 (GA)

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Registry record

NPI: 1154595676
Entity type: Individual
Sex (as registered): Female
NPI issued: 16 Apr 2008
Record last updated: 10 May 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.