Individual
LENNET FAY RADKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
7073
MN
363LF0000X
Family Nurse Practitioner
1625-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95079-30
WI STATE RN LICENSE
WI
Enumeration date
01/31/2011
Last updated
05/24/2021
Update your record
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