Individual provider · Type 1 NPI

Phyllis Annette Ingham, NP-C

Nurse Practitioner · Peru, IN

NPI number 1003328667 Active

Practice location

750 N Broadway
Peru, IN 46970-1027

Fax (260) 569-2121

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000X71009335A (IN)
Family Nurse Practitioner 363LF0000XAP134764 (TX)
Nurse Practitioner 363L00000XCNP-03521 (NM)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1003328667

Phyllis Annette Ingham, NP-C's National Provider Identifier is 1003328667, issued on Nov 3, 2017. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Peru, IN. The record was last updated on Dec 2, 2025.