Provider Demographics
NPI:1356758775
Name:INGLES, VIRGIE KAY (LRPSGT, RST)
Entity type:Individual
Prefix:MRS
First Name:VIRGIE
Middle Name:KAY
Last Name:INGLES
Suffix:
Gender:F
Credentials:LRPSGT, RST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MEDICAL CENTER DR
Mailing Address - Street 2:SLEEP DISORDERS CENTER
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461-5520
Mailing Address - Country:US
Mailing Address - Phone:985-264-7002
Mailing Address - Fax:
Practice Address - Street 1:100 MEDICAL CENTER DR
Practice Address - Street 2:SLEEP DISORDERS CENTER
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461-5520
Practice Address - Country:US
Practice Address - Phone:985-646-5711
Practice Address - Fax:985-646-5013
Is Sole Proprietor?:No
Enumeration Date:2014-07-17
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPOLY.000245246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA271770321OtherTAX ID
LA720276883OtherTAX ID