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NPI Code Detail

MEDICARE: KIMBERLY JEAN LUDWIG LPN

MEDICARE: KIMBERLY JEAN LUDWIG LPN
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
1164W00000XLicensed Practical NurseP52457IA

General Provider Information

NPI Number : 1003295056
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY JEAN LUDWIG LPN
Provider Business Mailing Address
First Line : 2214 NW 2ND ST
Second Line :
City : ANKENY
State : IA
Zip : 50023-1304
Country : US
Telephone Number : 515-490-6130
Fax Number :
Provider Business Practice Location Address
First Line : 1002 W WASHINGTON AVE
Second Line :
City : POLK CITY
State : IA
Zip : 50226-2132
Country : US
Telephone Number : 515-490-6130
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2015
Last Update Date : 05/22/2015

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