Individual
KIMBERLY RADTKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
3400 MINISTRY PKWY, WESTON, WI 54476-5220
(715) 393-3000
Mailing address
3400 MINISTRY PKWY, WESTON, WI 54476-5220
(715) 393-3000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4101
WI
363LG0600X
Gerontology Nurse Practitioner
4101
WI
364SA2200X
Adult Health Clinical Nurse Specialist
4101-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
128613
RN LICENSE
WI
01
—
4101
APNP LIC
WI
Enumeration date
05/13/2011
Last updated
06/05/2015
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