Provider Demographics
NPI:1124146972
Name:LEDOUX, PAULA JEANNE (RN)
Entity type:Individual
Prefix:MS
First Name:PAULA
Middle Name:JEANNE
Last Name:LEDOUX
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3227
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87501-0227
Mailing Address - Country:US
Mailing Address - Phone:505-753-2256
Mailing Address - Fax:505-753-2257
Practice Address - Street 1:714 CALLE DON DIEGO
Practice Address - Street 2:
Practice Address - City:ESPANOLA
Practice Address - State:NM
Practice Address - Zip Code:87532-3414
Practice Address - Country:US
Practice Address - Phone:505-367-3342
Practice Address - Fax:505-747-0936
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR44560163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse