Provider Demographics
NPI:1841704699
Name:INGRAM-JONES AND ASSOCIATES, LLC
Entity type:Organization
Organization Name:INGRAM-JONES AND ASSOCIATES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR/SOLE PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRINITY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:INGRAM-JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, CPNP, AFN-BC
Authorized Official - Phone:912-445-2517
Mailing Address - Street 1:299 MCGREGOR CIR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-9313
Mailing Address - Country:US
Mailing Address - Phone:912-445-2517
Mailing Address - Fax:
Practice Address - Street 1:10646 FORD AVE STE B
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324
Practice Address - Country:US
Practice Address - Phone:912-445-2517
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-30
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN163089363LP0200X, 2080C0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080C0008XAllopathic & Osteopathic PhysiciansPediatricsChild Abuse PediatricsGroup - Multi-Specialty
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Multi-Specialty