Provider Demographics
NPI:1003655580
Name:INGRAM, SHERIA LASHANETTE (LPN)
Entity type:Individual
Prefix:
First Name:SHERIA
Middle Name:LASHANETTE
Last Name:INGRAM
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:SHERIA
Other - Middle Name:L
Other - Last Name:INGRAM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:7101 SMOKE RANCH RD 2076
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128
Mailing Address - Country:US
Mailing Address - Phone:216-854-9879
Mailing Address - Fax:
Practice Address - Street 1:7101 SMOKE RANCH RD 2076
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128
Practice Address - Country:US
Practice Address - Phone:216-854-9879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV846350164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse