Individual
KATHERINE M RADAKOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
803 W ARLINGTON ST, BANGOR, MI 49013-1108
(269) 427-6810
(269) 427-6811
Mailing address
803 W ARLINGTON ST, BANGOR, MI 49013-1108
(269) 427-6810
(269) 427-6811
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
857942
—
363LF0000X
Family Nurse Practitioner
1139
AK
363LF0000X
Family Nurse Practitioner
Primary
4704285987
MI
363LF0000X
Family Nurse Practitioner
ARNP9321730
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003650500
—
FL
Enumeration date
03/29/2007
Last updated
03/26/2017
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