Provider Demographics
NPI:1649467341
Name:RIEGEL, LUDORA E (CRNP)
Entity type:Individual
Prefix:
First Name:LUDORA
Middle Name:E
Last Name:RIEGEL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 W 18TH ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19802-4707
Mailing Address - Country:US
Mailing Address - Phone:302-658-3331
Mailing Address - Fax:302-658-9306
Practice Address - Street 1:611 W 18TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-4707
Practice Address - Country:US
Practice Address - Phone:302-658-3331
Practice Address - Fax:302-658-9306
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009532363LW0102X
DELH-0000188363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health