Provider Demographics
NPI:1053839423
Name:LUDWIG, SHERRY TIDROSKI (RN,CDE)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:TIDROSKI
Last Name:LUDWIG
Suffix:
Gender:F
Credentials:RN,CDE
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:DENISE
Other - Last Name:TIDROSKI LUDWIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, CDE
Mailing Address - Street 1:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-424-1449
Mailing Address - Fax:239-424-1423
Practice Address - Street 1:12550 NEW BRITTANY BLVD STE 200
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-3655
Practice Address - Country:US
Practice Address - Phone:239-343-9261
Practice Address - Fax:239-343-9268
Is Sole Proprietor?:No
Enumeration Date:2017-09-06
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2811162163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator