Individual
MRS. PAULINA JEAN RADEMAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
4200 BROWNS LN, LOUISVILLE, KY 40220-1523
(502) 459-8900
Mailing address
8803 PETERBOROUGH DR, LOUISVILLE, KY 40222-5221
(502) 749-0293
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
3229P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000388346
BLUE SHIELD
KY
05
—
78006459
—
KY
01
—
P00283357
RR MEDICARE
KY
Enumeration date
10/10/2006
Last updated
07/08/2007
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