Provider Demographics
NPI:1396409637
Name:BOZEMAN, INGRID ALLISON (DNP, APRN, PMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:INGRID
Middle Name:ALLISON
Last Name:BOZEMAN
Suffix:
Gender:F
Credentials:DNP, APRN, PMHNP-BC
Other - Prefix:MISS
Other - First Name:INGRID
Other - Middle Name:ALLISON
Other - Last Name:LEVY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14615 NW 143RD PL
Mailing Address - Street 2:
Mailing Address - City:ALACHUA
Mailing Address - State:FL
Mailing Address - Zip Code:32615-8553
Mailing Address - Country:US
Mailing Address - Phone:352-275-7825
Mailing Address - Fax:
Practice Address - Street 1:14615 NW 143RD PL
Practice Address - Street 2:
Practice Address - City:ALACHUA
Practice Address - State:FL
Practice Address - Zip Code:32615-8553
Practice Address - Country:US
Practice Address - Phone:352-275-7825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-22
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11031001363LP0808X
FLRN9509685163WR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation