Provider Demographics
NPI:1194383273
Name:INGRAM, KATRINA VALENCIA
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:VALENCIA
Last Name:INGRAM
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 1:4407 COVINGTON ST APT 4
Mailing Address - Street 2:
Mailing Address - City:SUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20746-2518
Mailing Address - Country:US
Mailing Address - Phone:202-299-7816
Mailing Address - Fax:
Practice Address - Street 1:600 BARNES ST NE APT 405
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-1893
Practice Address - Country:US
Practice Address - Phone:202-905-6446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-03
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant