Provider Demographics
NPI:1891211967
Name:LUDEKING, CAROL (FNP-BC, DNP)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:LUDEKING
Suffix:
Gender:F
Credentials:FNP-BC, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3127 COUNTY ROAD A46
Mailing Address - Street 2:
Mailing Address - City:RIDGEWAY
Mailing Address - State:IA
Mailing Address - Zip Code:52165-8562
Mailing Address - Country:US
Mailing Address - Phone:563-419-7743
Mailing Address - Fax:
Practice Address - Street 1:901 MONTGOMERY ST
Practice Address - Street 2:
Practice Address - City:DECORAH
Practice Address - State:IA
Practice Address - Zip Code:52101-2325
Practice Address - Country:US
Practice Address - Phone:563-419-7743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-20
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA123651363LF0000X
MN5335363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily