Healthcare Provider Details

I. General information

NPI: 1760733489
Provider Name (Legal Business Name): LAUREN INGRAM RYAN AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN J INGRAM

II. Dates (important events)

Enumeration Date: 09/20/2012
Last Update Date: 11/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7777 HENNESSY BLVD STE 709
BATON ROUGE LA
70808-4300
US

IV. Provider business mailing address

7777 HENNESSY BLVD STE 709
BATON ROUGE LA
70808-4300
US

V. Phone/Fax

Practice location:
  • Phone: 225-765-7735
  • Fax:
Mailing address:
  • Phone: 225-765-7735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number6742
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number6742
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: