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General NPI Number Information
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NPI Number | 1982070389
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Entity Type | Organization
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Legal Business Name | BUSINESS HEALTH AFFILIATES
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Dates
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Enumeration Date | 08/19/2015
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Last Update Date | 08/19/2015
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Provider Practice Location Address
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Address Line | 3031 STANFORD RANCH RD 2-448
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City | ROCKLIN
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State | CA
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Zip | 95765-5554
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Country | US
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Telephone | 415-328-3456
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Fax |
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Provider Business Mailing Address
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Address Line | 3031 STANFORD RANCH RD 2-448
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City | ROCKLIN
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State | CA
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Zip | 95765-5554
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Country | US
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Telephone | 415-328-3456
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Fax |
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Authorized Official
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Title or Position | PRINCIPAL
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Name | MAUREEN LUDWIG
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Credential | NP
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Telephone | 415-328-3456
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 321577
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License Number State | CA
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