Healthcare Provider Details

I. General information

NPI: 1457875239
Provider Name (Legal Business Name): RACHEL LUDWIG FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2017
Last Update Date: 10/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6100 ROCKSIDE WOODS BLVD N STE 425
INDEPENDENCE OH
44131
US

IV. Provider business mailing address

4312 ROOT RD
NORTH OLMSTED OH
44070-2729
US

V. Phone/Fax

Practice location:
  • Phone: 216-643-2780
  • Fax: 216-524-0111
Mailing address:
  • Phone: 440-213-6903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP021510
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: