Provider Demographics
NPI:1891503900
Name:YEDIGAROVA, LYUDMILA ALEKSEYEVNA
Entity type:Individual
Prefix:
First Name:LYUDMILA
Middle Name:ALEKSEYEVNA
Last Name:YEDIGAROVA
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 1:311 SANTE FE TRL
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521-3255
Mailing Address - Country:US
Mailing Address - Phone:402-570-6630
Mailing Address - Fax:
Practice Address - Street 1:3123 N HILL RD APT 204
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68504-4723
Practice Address - Country:US
Practice Address - Phone:402-570-6630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-20
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider