Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 4704180121 | MI |
NPI | 1003066218 |
---|---|
Provider Name | Terri Lynn Ladwig |
First Address | Ann Arbor, MI 48105-9484 |
Second Address | Ypsilanti, MI 48197-2982 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2008 |
Last Update Date | 25/08/2016 |