MEDICARE: DEATRICE INGRAM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1225601917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEATRICE INGRAM

Provider Business Mailing Address
First Line	:	410 S RAMPART BLVD STE 390
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-5749
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8125 BAY SPRINGS DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-1624
Country	:	US
Telephone Number	:	310-562-8331
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2021
Last Update Date	:	07/20/2021

Similar Medicare Providers

1225392590 — ANGELICA CRUZ
Practice Location Address:

1624 PALMAE WAY
LAS VEGAS, NV
89128-3246

Practice Phone: 702-327-0558
Practice Fax:

1730214651 — EAGLE QUEST OF NEVADA, INCORPORATED
Practice Location Address:

4612 EVAN RIDGE CT
LAS VEGAS, NV
89129-1624

Practice Phone: 702-375-1488
Practice Fax: 702-396-4193

1124229604 — CAMILLE AMOY CADOGAN
Practice Location Address:

4612 EVAN RIDGE CT
LAS VEGAS, NV
89129-1624

Practice Phone: 702-646-5437
Practice Fax:

1508122144 — YOLANDA UBANDO MEMPIN DUMDUMAYA
Practice Location Address:

1624 PALM ST UNIT 80
LAS VEGAS, NV
89104-4709

Practice Phone: 702-722-5321
Practice Fax:

1881005072 — MRS. JOYCE BETH MARSTON M.A.,CCC-SLP
Practice Location Address:

11212 SHADOW NOOK CT
LAS VEGAS, NV
89144-1624

Practice Phone: 702-283-3217
Practice Fax:

1902455066 — RICKY LEE FLOOD
Practice Location Address:

1624 PALM ST UNIT 121
LAS VEGAS, NV
89104-4711

Practice Phone: 702-929-5110
Practice Fax:

Directions to “ DEATRICE INGRAM ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.