Provider Demographics
NPI:1801615067
Name:EXCELLENT, LUDNIE (APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:LUDNIE
Middle Name:
Last Name:EXCELLENT
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6825 BIG PINE KEY ST
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-7631
Mailing Address - Country:US
Mailing Address - Phone:561-633-1223
Mailing Address - Fax:
Practice Address - Street 1:6825 BIG PINE KEY ST
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-7631
Practice Address - Country:US
Practice Address - Phone:561-633-1223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-05
Last Update Date:2024-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11035718363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health