Individual
ELLEN A RADOCAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
140B SCHOOL CREEK TRL, LUXEMBURG, WI 54217-1095
(920) 845-1370
(920) 845-1379
Mailing address
PO BOX 22487, GREEN BAY, GREEN BAY, WI 54305-2487
(920) 445-7210
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
174211-30
WI
363LF0000X
Family Nurse Practitioner
Primary
5967-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13673570
CAQH
—
01
—
F0814117
AMERICAN ACADEMY OF NURSE PRACTITIONERS
—
Enumeration date
07/03/2014
Last updated
09/12/2023
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