| Doctor Name: | SALLY JO LEDVINA |
| NPI Number: | 1730474347 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APNP |
| License Number: | 4387-033 |
| Business Practice Address: | E1430 Krines Rd Luxemburg, WI - 542177731 |
| Business Phone Number: | 9208636580 |
| Business Fax Number: | |
| Mailing Address: | E1430 Krines Rd, LUXEMBURG |
| State: | WI |
| Postal Code: | 542177731 |
| Phone Number: | 9208636580 |
| Fax Number: | |
| NPI Enumeration Date: | 06/10/2011 |
| NPI Last Update Date: | 06/10/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 4387-033 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |