Provider Demographics
NPI:1427697069
Name:INGRAM, KYLA ANNE (DNP, ARNP, FNP-C)
Entity type:Individual
Prefix:
First Name:KYLA
Middle Name:ANNE
Last Name:INGRAM
Suffix:
Gender:F
Credentials:DNP, ARNP, FNP-C
Other - Prefix:
Other - First Name:KYLA
Other - Middle Name:ANNE
Other - Last Name:REYES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, ARNP, FNP-C
Mailing Address - Street 1:3939 12TH ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50313-3221
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:800 E 1ST ST STE 2400
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50021-2077
Practice Address - Country:US
Practice Address - Phone:515-452-0600
Practice Address - Fax:515-452-0606
Is Sole Proprietor?:No
Enumeration Date:2019-12-30
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA155606363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily