MEDICARE: JANE LUDLOW R.N.

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
1	163W00000X	Registered Nurse	RN205362	OH

General Provider Information

NPI Number	:	1235531575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANE LUDLOW R.N.

Provider Business Mailing Address
First Line	:	6890 ROSEWOOD QUINCY RD
Second Line	:
City	:	DE GRAFF
State	:	OH
Zip	:	43318-9521
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6890 ROSEWOOD QUINCY RD
Second Line	:
City	:	DE GRAFF
State	:	OH
Zip	:	43318-9521
Country	:	US
Telephone Number	:	937-362-3931
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/18/2014
Last Update Date	:	09/18/2014

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