Individual
JENNIFER L LADWIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
721 S CALUMET ST, VALDERS, WI 54245-9583
(920) 775-4111
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2932
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2932
WI LICENSE
WI
05
—
36012900
—
WI
Enumeration date
09/07/2006
Last updated
09/05/2024
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