Provider Demographics
NPI:1760375430
Name:NUMA TMS LLC
Entity type:Organization
Organization Name:NUMA TMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:L
Authorized Official - Last Name:INGRAM
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN, PMHNP-BC
Authorized Official - Phone:808-391-5225
Mailing Address - Street 1:98-1247 KAAHUMANU ST STE 106
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-5310
Mailing Address - Country:US
Mailing Address - Phone:808-583-6411
Mailing Address - Fax:808-480-7589
Practice Address - Street 1:10120 S EASTERN AVE STE 130
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-3953
Practice Address - Country:US
Practice Address - Phone:702-760-1975
Practice Address - Fax:808-480-7589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty