1366683286 NPI number — MRS. BRENDA H. LUDWIG EDD, FNP-BC, RN

Table of content: MRS. BRENDA H. LUDWIG EDD, FNP-BC, RN (NPI 1366683286)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366683286 NPI number — MRS. BRENDA H. LUDWIG EDD, FNP-BC, RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LUDWIG
Provider First Name:
BRENDA
Provider Middle Name:
H.
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
EDD, FNP-BC, RN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LUDWIG
Provider Other First Name:
BRENDA
Provider Other Middle Name:
H.
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
EDD, MS, APRN, FNP
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1366683286
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/07/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
109 WINDEMERE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENVILLE
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29615-1635
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
864-901-8311
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
89A SONIA DR
Provider Second Line Business Practice Location Address:
MEDICAL CONSULTANTS OF THE CAROLINAS
Provider Business Practice Location Address City Name:
GREER
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29650-4540
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-530-0302
Provider Business Practice Location Address Fax Number:
864-530-0304
Provider Enumeration Date:
03/23/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  RX 3763 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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