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Individual
MRS. TRACY L RADMER
Active
Individual
MRS. TRACY L RADMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N. CDE
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
111192
WI
163WD0400X
Diabetes Educator Registered Nurse
111192
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38226800
PROVIDER NUMBER
WI
Enumeration date
09/09/2008
Last updated
09/09/2008
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