Provider Demographics
NPI:1700832839
Name:LUEDEKE, TODD (CRNA)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:
Last Name:LUEDEKE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 N PEARL ST
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NE
Mailing Address - Zip Code:68787-1902
Mailing Address - Country:US
Mailing Address - Phone:402-375-3000
Mailing Address - Fax:402-375-3777
Practice Address - Street 1:214 N PEARL ST
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NE
Practice Address - Zip Code:68787-1902
Practice Address - Country:US
Practice Address - Phone:402-375-3000
Practice Address - Fax:402-375-3777
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE100571 CRNA 50658 RN367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered