Provider Demographics
NPI:1003524398
Name:INGRAM, HAYDEN ROY (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:HAYDEN
Middle Name:ROY
Last Name:INGRAM
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1188 DELTA LN
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-7267
Mailing Address - Country:US
Mailing Address - Phone:504-481-3126
Mailing Address - Fax:
Practice Address - Street 1:1188 DELTA LN
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-7267
Practice Address - Country:US
Practice Address - Phone:504-481-3126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-07
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant