Healthcare Provider Details

I. General information

NPI: 1922916501
Provider Name (Legal Business Name): ELIZABETH DUDDEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 M ST
LINCOLN NE
68508-2278
US

IV. Provider business mailing address

921 M ST
LINCOLN NE
68508-2278
US

V. Phone/Fax

Practice location:
  • Phone: 406-770-9447
  • Fax:
Mailing address:
  • Phone: 406-770-9447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: