Provider Demographics
NPI:1124228085
Name:LUEDKE, SERENITY D (APRN)
Entity Type:Individual
Prefix:MRS
First Name:SERENITY
Middle Name:D
Last Name:LUEDKE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 N COTNER BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-2339
Mailing Address - Country:US
Mailing Address - Phone:402-464-8636
Mailing Address - Fax:402-464-8408
Practice Address - Street 1:630 N COTNER BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68505-2339
Practice Address - Country:US
Practice Address - Phone:402-464-8636
Practice Address - Fax:402-464-8408
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110860363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily