Provider Demographics
NPI:1649086521
Name:LUDWIG, DOROTHY IRENE (NURSING ASSISTANT)
Entity type:Individual
Prefix:
First Name:DOROTHY
Middle Name:IRENE
Last Name:LUDWIG
Suffix:
Gender:F
Credentials:NURSING ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 E ISABELLA ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-4105
Mailing Address - Country:US
Mailing Address - Phone:717-773-3713
Mailing Address - Fax:
Practice Address - Street 1:102 E ISABELLA ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-4105
Practice Address - Country:US
Practice Address - Phone:717-773-3713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00221019376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide