MEDICARE: SALEM LUDLOW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	98027163102	UT

General Provider Information

NPI Number	:	1558206904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SALEM LUDLOW

Provider Business Mailing Address
First Line	:	4819 S KINGS ROW DR APT 23
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117-5980
Country	:	US
Telephone Number	:	801-651-8401
Fax Number	:

Provider Business Practice Location Address
First Line	:	4819 S KINGS ROW DR APT 23
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117-5980
Country	:	US
Telephone Number	:	801-651-8401
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/22/2026
Last Update Date	:	04/22/2026

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Directions to “ SALEM LUDLOW ” Practice Location

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