Provider Demographics
NPI:1235571159
Name:INGYA, MWUESE (LVN)
Entity Type:Individual
Prefix:
First Name:MWUESE
Middle Name:
Last Name:INGYA
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10108 CALLE MARINERO
Mailing Address - Street 2:APT 39
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91977-7100
Mailing Address - Country:US
Mailing Address - Phone:619-243-9338
Mailing Address - Fax:
Practice Address - Street 1:10108 CALLE MARINERO
Practice Address - Street 2:APT 39
Practice Address - City:SPRING VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91977-7100
Practice Address - Country:US
Practice Address - Phone:619-243-9338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-19
Last Update Date:2018-10-31
Deactivation Date:2015-06-03
Deactivation Code:
Reactivation Date:2018-10-31
Provider Licenses
StateLicense IDTaxonomies
CA260260164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse