Mary Katherine Luddy Anderson, MD

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Omaha, NE

NPI 1174209308 · NPPES record last updated Jun 22, 2023

Key facts

NPI
1174209308
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
982055 Nebraska Medical Ctr
Omaha, NE 68198-2055
Phone
(402) 559-0390
NPI assigned
Jun 22, 2023
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20230815004261 NE Order and Referring Only - Internal Medicine
Practitioner - Internal Medicine
0941662449

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

982055 Nebraska Medical Ctr
Omaha, NE 68198-2055

Mailing address

982055 Nebraska Medical Ctr
Omaha, NE 68198-2055

Other providers in Omaha, NE

All providers in Omaha, NE · Student in an Organized Health Care Education/Training Program in Nebraska

Sources for this page

Verify at the official NPI Registry.