Samantha Radke
Registered Nurse in Jackson, WI. Individual provider (NPI-1).
NPI number1124459243
StatusActive
Last updated in NPPESFeb 20, 2014
Details
- NPI
- 1124459243
- Entity type
- Individual (NPI-1)
- Name
- Samantha Radke
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Dec 1, 2013
- Last updated
- Feb 20, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163W00000X | Registered Nurse | 191522-30 | WI | Yes |
Practice location
W206n16731 Blackberry CirUnit 1525
Jackson, WI 53037-8963
Phone 262-573-9328
Mailing address
W206n16731 Blackberry CirUnit 1525
Jackson, WI 53037-8963
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