Provider Demographics
NPI:1144527821
Name:STIER, INGRID (NP)
Entity type:Individual
Prefix:
First Name:INGRID
Middle Name:
Last Name:STIER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 MOUNTAIN RIDGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:CLARKESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30523-3398
Mailing Address - Country:US
Mailing Address - Phone:401-479-7879
Mailing Address - Fax:912-000-0000
Practice Address - Street 1:2782 N COBB PKWY
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-3472
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:912-000-0000
Is Sole Proprietor?:No
Enumeration Date:2011-02-16
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA140664363LF0000X
GARN140664363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003106240BMedicaid
GAP00915512OtherRR CARE
GA583542OtherWELLCARE
GA003106240BMedicaid