Provider Demographics
NPI:1962849323
Name:LUEDEMAN, BRENDA KVAMME (DNP, MSN, ARNP)
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:KVAMME
Last Name:LUEDEMAN
Suffix:
Gender:F
Credentials:DNP, MSN, ARNP
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 9438
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33883-9438
Mailing Address - Country:US
Mailing Address - Phone:863-207-3330
Mailing Address - Fax:
Practice Address - Street 1:122 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-6313
Practice Address - Country:US
Practice Address - Phone:863-294-0985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-25
Last Update Date:2013-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL879772363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health