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JULEE R RADTKE NP
Adult Health >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1235150046
Individual Registrant: JULEE R RADTKE NP
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
111 ANNA ST WATERLOO, WI 53594-1184 US
Tel: 920-478-3776 Fax: 920-478-3979
Tel: 920-478-3776 Fax: 920-478-3979
Contact information for business:
4260 S JORDAN DR MC FARLAND, WI 53558-9057 US
Tel: 608-835-7113 Fax: --
Tel: 608-835-7113 Fax: --
Registration Information:
NPI: 1235150046
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363LA2200X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Adult Health | WI | 1357-033 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 43882600 | WI | 05 | |
| DEAN HEALTH CARE | 13998 | WI | 01 |
| UNITY | 20274908702 | WI | 01 |
