Provider Demographics
NPI:1679696686
Name:LUDWIG, TRISHA O (CNM)
Entity Type:Individual
Prefix:MS
First Name:TRISHA
Middle Name:O
Last Name:LUDWIG
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 N MAIN STREET EXT BLDG 2
Mailing Address - Street 2:SUITE 3A&B
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-2400
Mailing Address - Country:US
Mailing Address - Phone:203-397-5286
Mailing Address - Fax:203-643-8459
Practice Address - Street 1:850 N MAIN STREET EXT BLDG 2
Practice Address - Street 2:SUITE 3A&B
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-2400
Practice Address - Country:US
Practice Address - Phone:203-397-5286
Practice Address - Fax:203-643-8459
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000291176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife