Individual
MR. MIKE RADY
Active
Individual
MR. MIKE RADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4832386-8900
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4832386-4405
DIVISION OF OCCUPATIONAL & PROFESSIONAL LICENSING
UT
01
—
4832386-8900
DIVISION OF OCCUPATIONAL & PROFESSIONAL LICENSING
UT
Enumeration date
10/16/2019
Last updated
10/16/2019
Update your record
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