Individual
MRS. TRACY L RADMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N. CDE
Contact information
Practice address
W272S4117 OVERLOOK LN, WAUKESHA, WI 53189-6534
(262) 542-1806
Mailing address
W272S4117 OVERLOOK LN, WAUKESHA, WI 53189-6534
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
111192
WI
163WD0400X
Diabetes Educator Registered Nurse
111192
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38226800
PROVIDER NUMBER
WI
Enumeration date
09/09/2008
Last updated
09/09/2008
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