Provider Demographics
NPI:1558161927
Name:UDEN, JODY
Entity type:Individual
Prefix:
First Name:JODY
Middle Name:
Last Name:UDEN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 W ELM ST
Mailing Address - Street 2:
Mailing Address - City:KENESAW
Mailing Address - State:NE
Mailing Address - Zip Code:68956-1539
Mailing Address - Country:US
Mailing Address - Phone:402-984-4163
Mailing Address - Fax:
Practice Address - Street 1:312 W ELM ST
Practice Address - Street 2:
Practice Address - City:KENESAW
Practice Address - State:NE
Practice Address - Zip Code:68956-1539
Practice Address - Country:US
Practice Address - Phone:402-984-4163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-15
Last Update Date:2025-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion