Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 53292 | TN |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 53292 | TN |
NPI | 1285676668 |
---|---|
Provider Name | Dr. Lael M Luedtke |
First Address | Nashville, TN 37204-3708 |
Second Address | Nashville, TN 37209-2560 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 15/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H24222 | (02) | |
Q018504 | (05) | TN |