Individual
IMELDA VELASCO INGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
325 S JACKSON ST, COVINGTON, LA 70433-3096
(225) 363-8884
(985) 871-1480
Mailing address
325 S JACKSON ST, COVINGTON, LA 70433-3009
(225) 363-8884
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN129197
LA
Other
Enumeration date
05/10/2022
Last updated
05/10/2022
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