Provider Demographics
NPI:1063097327
Name:LUEDERS, KIMBERLY R (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:R
Last Name:LUEDERS
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 PROVIDENCE RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NE
Mailing Address - Zip Code:68787-1299
Mailing Address - Country:US
Mailing Address - Phone:402-375-7920
Mailing Address - Fax:402-375-7605
Practice Address - Street 1:1200 PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NE
Practice Address - Zip Code:68787-1299
Practice Address - Country:US
Practice Address - Phone:402-375-7920
Practice Address - Fax:402-375-7605
Is Sole Proprietor?:No
Enumeration Date:2021-03-17
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10893183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist