Provider Demographics
NPI:1215674668
Name:LADUCER, PATTY ANN
Entity type:Individual
Prefix:MS
First Name:PATTY
Middle Name:ANN
Last Name:LADUCER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2046
Mailing Address - Street 2:
Mailing Address - City:BELCOURT
Mailing Address - State:ND
Mailing Address - Zip Code:58316-2046
Mailing Address - Country:US
Mailing Address - Phone:701-550-2918
Mailing Address - Fax:701-244-0361
Practice Address - Street 1:9730 BIA ROAD 5
Practice Address - Street 2:
Practice Address - City:BELCOURT
Practice Address - State:ND
Practice Address - Zip Code:58316-7701
Practice Address - Country:US
Practice Address - Phone:701-550-2918
Practice Address - Fax:701-244-0361
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant