Provider Demographics
NPI:1922498674
Name:LUDWIG, JENNIFER ANNE (RN)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:ANNE
Last Name:LUDWIG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 88
Mailing Address - Street 2:
Mailing Address - City:DRYDEN
Mailing Address - State:NY
Mailing Address - Zip Code:13053-0088
Mailing Address - Country:US
Mailing Address - Phone:607-844-9654
Mailing Address - Fax:607-844-3826
Practice Address - Street 1:43 MAIN ST
Practice Address - Street 2:-NO MAIL AT THIS LOCATION-
Practice Address - City:FREEVILLE
Practice Address - State:NY
Practice Address - Zip Code:13068-9599
Practice Address - Country:US
Practice Address - Phone:607-844-9251
Practice Address - Fax:607-844-3826
Is Sole Proprietor?:No
Enumeration Date:2015-02-03
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY690086163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse