Provider Demographics
NPI:1104637149
Name:INGRAM, ALLISON GABRIELLE (IBCLC)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:GABRIELLE
Last Name:INGRAM
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 SHAMROCK RD
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-1345
Mailing Address - Country:US
Mailing Address - Phone:704-685-1509
Mailing Address - Fax:
Practice Address - Street 1:602 SHAMROCK RD
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-1345
Practice Address - Country:US
Practice Address - Phone:704-685-1509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-317028174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN