Petra I. Luddy, R.N.

Individual provider Active NPI Home Health Registered Nurse · Harwich, MA

NPI 1760655450 · NPPES record last updated Apr 2, 2008

Key facts

NPI
1760655450
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Registered Nurse 163WH0200X
License
142189 (MA)
Practice address
244 Sisson Rd
Harwich, MA 02645-2617
Phone
(508) 737-9925
NPI assigned
Apr 2, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
142189MAMDHome Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 142189 MA Yes

Addresses

Primary practice location

244 Sisson Rd
Harwich, MA 02645-2617

Mailing address

244 Sisson Rd
Harwich, MA 02645-2617
Phone (508) 737-9925

Other identifiers

IdentifierTypeStateIssuer
142189OtherMAR.N.

Other providers in Harwich, MA

All providers in Harwich, MA · Home Health Registered Nurse in Massachusetts

Sources for this page

Verify at the official NPI Registry.