Healthcare Provider Details

I. General information

NPI: 1659923001
Provider Name (Legal Business Name): KAITLYN MCDONALD LUDWIG PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAITLYN LITTLEFIELD MCDONALD PA-C

II. Dates (important events)

Enumeration Date: 07/15/2019
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 W HAMPDEN AVE UNIT 103
ENGLEWOOD CO
80110-7330
US

IV. Provider business mailing address

5102 S BROADWAY
ENGLEWOOD CO
80113-6706
US

V. Phone/Fax

Practice location:
  • Phone: 303-761-1699
  • Fax:
Mailing address:
  • Phone: 720-457-9100
  • Fax: 720-457-9333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: