Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 321577 | CA |
N | 363LC1500X | Nurse Practitioner - Community Health | 321577 | CA |
NPI | 1932516390 |
---|---|
Provider Name | Maureen Ludwig |
First Address | Rocklin, CA 95765-5604 |
Second Address | Rocklin, CA 95765-5554 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2014 |
Last Update Date | 14/07/2015 |