Provider Demographics
NPI:1750266789
Name:LUETCHENS, BRENTON TODD
Entity type:Individual
Prefix:
First Name:BRENTON
Middle Name:TODD
Last Name:LUETCHENS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6555 PHEASANT RUN PL STE 295
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-2420
Mailing Address - Country:US
Mailing Address - Phone:402-499-0736
Mailing Address - Fax:
Practice Address - Street 1:6555 PHEASANT RUN PL
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-2420
Practice Address - Country:US
Practice Address - Phone:402-499-0736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
372500000X
NE372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider