Provider Demographics
NPI:1467873372
Name:LUDWIG, DIANNE
Entity Type:Individual
Prefix:MS
First Name:DIANNE
Middle Name:
Last Name:LUDWIG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 FAIRGROUNDS PLZ
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05661-8520
Mailing Address - Country:US
Mailing Address - Phone:802-888-9894
Mailing Address - Fax:802-888-9897
Practice Address - Street 1:80 FAIRGROUNDS PLZ
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:VT
Practice Address - Zip Code:05661-8520
Practice Address - Country:US
Practice Address - Phone:802-888-9894
Practice Address - Fax:802-888-9897
Is Sole Proprietor?:No
Enumeration Date:2013-12-18
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT033002671183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist