Provider Demographics
NPI:1083188395
Name:INGEMANSON, CATHERINE GEMMA
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:GEMMA
Last Name:INGEMANSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:576 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02188-3420
Mailing Address - Country:US
Mailing Address - Phone:781-408-2228
Mailing Address - Fax:
Practice Address - Street 1:576 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02188-3420
Practice Address - Country:US
Practice Address - Phone:781-408-2228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-20
Last Update Date:2019-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN95544164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse