Individual
MARY LUEDTKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
301 W HOMER ST, MICHIGAN CITY, IN 46360-4358
(219) 879-8511
Mailing address
2000 GREEN RD, SUITE 300, ANN ARBOR, MI 48105-1598
(734) 995-3764
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP9278988
FL
363LF0000X
Family Nurse Practitioner
71001174A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000302800
—
FL
Enumeration date
06/13/2006
Last updated
03/17/2009
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