Provider Demographics
NPI:1073792750
Name:INGWERSON, JULIA (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:
Last Name:INGWERSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 S GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:KS
Mailing Address - Zip Code:66536-1637
Mailing Address - Country:US
Mailing Address - Phone:785-437-3734
Mailing Address - Fax:785-437-6186
Practice Address - Street 1:206 S GRAND AVE
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:KS
Practice Address - Zip Code:66536-1637
Practice Address - Country:US
Practice Address - Phone:785-437-3734
Practice Address - Fax:785-437-6186
Is Sole Proprietor?:No
Enumeration Date:2007-10-30
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45891363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily