Individual
KELLY RADTKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, FNP
Contact information
Practice address
12605 E 16TH AVE, AURORA, CO 80045-2545
(720) 848-0006
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
(303) 493-7000
(303) 493-7202
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.1658001
CO
363LA2200X
Adult Health Nurse Practitioner
Primary
APN.0994275-NP
CO
363LF0000X
Family Nurse Practitioner
APN.0994275-NP
CO
Other
Enumeration date
03/09/2013
Last updated
03/28/2019
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