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1528166964
BRENT E INGVARDSEN
SHREVEPORT, LA
NPI
1528166964
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: LA AP04397)
Enumeration Date
2006-09-20
Last Update Date
2007-07-08
Business Address
-- BRENT E INGVARDSEN CRNA
1501 KINGS HWY
SHREVEPORT, LA 71103-4228
Phone number: 318-675-5581
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Mailing Address
-- BRENT E INGVARDSEN CRNA
511 DIXIE SWIM CLUB RD
STONEWALL, LA 71078-9538
Phone number: 318-933-8201
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