Provider Demographics
NPI:1609381284
Name:LADUKE, ALYSHA N (LPN)
Entity Type:Individual
Prefix:
First Name:ALYSHA
Middle Name:N
Last Name:LADUKE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 EAST BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14610-1522
Mailing Address - Country:US
Mailing Address - Phone:585-739-0148
Mailing Address - Fax:
Practice Address - Street 1:81 EAST BLVD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14610-1522
Practice Address - Country:US
Practice Address - Phone:585-739-0148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-05
Last Update Date:2017-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY319182164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse