1881061471 NPI number — MRS. AMIEE LYNN LUEDEMAN NURSE PRACTITIONER

Table of content: MRS. AMIEE LYNN LUEDEMAN NURSE PRACTITIONER (NPI 1881061471)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881061471 NPI number — MRS. AMIEE LYNN LUEDEMAN NURSE PRACTITIONER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LUEDEMAN
Provider First Name:
AMIEE
Provider Middle Name:
LYNN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
NURSE PRACTITIONER
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WITTENBURG
Provider Other First Name:
AMIEE
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
ARNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1881061471
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/26/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1026 A AVE NE
Provider Second Line Business Mailing Address:
ST. LUKE'S HOSPITAL UNITY POINT
Provider Business Mailing Address City Name:
CEDAR RAPIDS
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52402-5036
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
319-369-7211
Provider Business Mailing Address Fax Number:
319-286-4655

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1026 A AVE NE
Provider Second Line Business Practice Location Address:
ST. LUKE'S HOSPITAL
Provider Business Practice Location Address City Name:
CEDAR RAPIDS
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52402-5036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-369-7211
Provider Business Practice Location Address Fax Number:
319-286-4655
Provider Enumeration Date:
08/31/2015

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: 363L00000X , with the licence number:  H119140 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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