Provider Demographics
NPI:1205493194
Name:INGRAM, DIONDRIA E (CNM)
Entity type:Individual
Prefix:
First Name:DIONDRIA
Middle Name:E
Last Name:INGRAM
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 6730
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85246-6730
Mailing Address - Country:US
Mailing Address - Phone:480-821-3600
Mailing Address - Fax:480-857-2667
Practice Address - Street 1:5171 S CUB LAKE RD STE 340
Practice Address - Street 2:
Practice Address - City:SHOW LOW
Practice Address - State:AZ
Practice Address - Zip Code:85901-7888
Practice Address - Country:US
Practice Address - Phone:480-821-3600
Practice Address - Fax:480-857-2667
Is Sole Proprietor?:No
Enumeration Date:2019-05-25
Last Update Date:2025-04-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ322288367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife