=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861202582
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JULIA ANNE LUDLOW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/14/2025
-----------------------------------------------------
Last Update Date | 08/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1933 SMITH AVE
-----------------------------------------------------
City | PLATTSMOUTH
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68048-2621
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-650-8857
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 20003 TREASURE ISLAND RD
-----------------------------------------------------
City | PLATTSMOUTH
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68048-7167
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-650-8857
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 385HR2060X
-----------------------------------------------------
Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------