Individual
INGRID LYN IVERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
CO4074
CO
225100000X
Physical Therapist
NM3725
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CO4074
LICENSE
CO
01
—
NM3725
NM LICENSE
NM
Enumeration date
10/27/2009
Last updated
10/27/2009
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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