Healthcare Provider Details

I. General information

NPI: 1356232185
Provider Name (Legal Business Name): ALYSSA NICOLE LUDWIG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2025
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 S FIFTH ST
LYNCH NE
68746-3013
US

IV. Provider business mailing address

PO BOX 118
LYNCH NE
68746-0118
US

V. Phone/Fax

Practice location:
  • Phone: 402-569-2451
  • Fax:
Mailing address:
  • Phone: 402-569-2451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number116152
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: