| Doctor Name: | KATHLEEN L LUDWIKOWSKI |
| NPI Number: | 1073506119 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 4688-33 |
| Business Practice Address: | 317 Dewitt St Portage, WI - 539012155 |
| Business Phone Number: | 6082979680 |
| Business Fax Number: | 6087451757 |
| Mailing Address: | N5427 County Road Y, MONTELLO |
| State: | WI |
| Postal Code: | 539498307 |
| Phone Number: | 6082979680 |
| Fax Number: | |
| NPI Enumeration Date: | 08/24/2005 |
| NPI Last Update Date: | 10/16/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 4688-33 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |