Individual
INGRID HALVORSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1562 OPOSSUMTOWN PIKE, FREDERICK, MD 21702
(301) 662-8477
Mailing address
PO BOX 37086, BALTIMORE, MD 21297-3086
(240) 344-1106
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
R175046
MD
Other
Enumeration date
04/16/2014
Last updated
05/15/2019
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