Provider Demographics
NPI:1508099607
Name:INGA, ERIN LYNN (RN)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:LYNN
Last Name:INGA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:ERIN
Other - Middle Name:LYNN
Other - Last Name:MAHONEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:3501 SE WILLOUGHBY BLVD
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-5059
Mailing Address - Country:US
Mailing Address - Phone:772-288-0304
Mailing Address - Fax:772-288-1371
Practice Address - Street 1:3501 SE WILLOUGHBY BLVD
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-5059
Practice Address - Country:US
Practice Address - Phone:772-288-0304
Practice Address - Fax:772-288-1371
Is Sole Proprietor?:No
Enumeration Date:2009-08-24
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9295848163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse