Individual
TIFFANY J RADKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1700 UNIVERSITY AVE W FL 1, SAINT PAUL, MN 55104-3727
(651) 232-2002
Mailing address
1700 UNIVERSITY AVE W FL 1, SAINT PAUL, MN 55104-3727
(651) 232-2002
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209-011702
IL
363LA2100X
Acute Care Nurse Practitioner
Primary
5391
MN
Other
Enumeration date
08/14/2014
Last updated
05/03/2018
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