Individual
MR. KENNETH FRANCIS RADERSTORF III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1753 FULTON ST, ELKHART, IN 46514-1927
(574) 293-9448
(574) 293-9480
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
(547) 647-2129
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28222082A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300065926
—
IN
Enumeration date
05/19/2021
Last updated
01/14/2026
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