Provider Demographics
NPI:1447029012
Name:INGRAM, BRANDY DUNYELLE
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:DUNYELLE
Last Name:INGRAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 6TH ST NE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44704-1564
Mailing Address - Country:US
Mailing Address - Phone:330-906-4526
Mailing Address - Fax:
Practice Address - Street 1:1222 6TH ST NE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44704-1564
Practice Address - Country:US
Practice Address - Phone:330-906-4526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-25
Last Update Date:2023-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health