Provider Demographics
NPI:1710639737
Name:LUDWIG, MICHELLE ANDREA (CD(DONA))
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:ANDREA
Last Name:LUDWIG
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10401 N 32ND ST STE A
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-3850
Mailing Address - Country:US
Mailing Address - Phone:720-409-8977
Mailing Address - Fax:
Practice Address - Street 1:10401 N 32ND ST STE A
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-3850
Practice Address - Country:US
Practice Address - Phone:720-409-8977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-20
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
11435374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
Provider Identifiers
StateIdentifier IDID TypeIssuer
11435OtherDONA