Healthcare Provider Details

I. General information

NPI: 1811388960
Provider Name (Legal Business Name): ANNA M LADOUCE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNA M CASSESE

II. Dates (important events)

Enumeration Date: 02/11/2015
Last Update Date: 09/28/2023
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 HOBART ST
CADILLAC MI
49601-2331
US

IV. Provider business mailing address

2795 KETTLE LAKE RD NE
KALKASKA MI
49646-8234
US

V. Phone/Fax

Practice location:
  • Phone: 231-876-7394
  • Fax:
Mailing address:
  • Phone: 616-901-0651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704259877
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704259877
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: