Provider Demographics
NPI:1396551354
Name:LUETHJE, JANICE (APRN)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:LUETHJE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6525 CORNFLOWER DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68504-4657
Mailing Address - Country:US
Mailing Address - Phone:402-314-1497
Mailing Address - Fax:
Practice Address - Street 1:755 FALLBROOK BLVD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68521-4637
Practice Address - Country:US
Practice Address - Phone:402-441-3575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE87994163W00000X
NE115429363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse