Organization
RADIANT RECHARGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA L FRAZIER RN (COO)
(309) 712-1815
Entity
Organization
Contact information
Practice address
466 SW PORT ST LUCIE BLVD STE 114, PORT ST LUCIE, FL 34953-2091
(772) 837-0500
Mailing address
6124 NW BUTTERFLY ORCHID PL, PORT ST LUCIE, FL 34986-3224
(309) 712-1815
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
—
—
163WH0200X
Home Health Registered Nurse
Primary
—
—
246RP1900X
Phlebotomy Technician
—
—
251J00000X
Nursing Care Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093305062
REGISTERED NURSE
IL
Enumeration date
01/29/2024
Last updated
01/29/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us