Provider Demographics
NPI:1649661810
Name:LUEDEMAN, JENNA
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:LUEDEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 11TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SIBLEY
Mailing Address - State:IA
Mailing Address - Zip Code:51249-1134
Mailing Address - Country:US
Mailing Address - Phone:712-330-8824
Mailing Address - Fax:
Practice Address - Street 1:8301 E PRENTICE AVE
Practice Address - Street 2:STE 207
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2903
Practice Address - Country:US
Practice Address - Phone:719-630-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-10
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant