Individual
TATYANA TRENDAFILOVA RADULOVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
2350 N LAKE DR, SUITE 302, MILWAUKEE, WI 53211-4528
(414) 298-7104
(414) 298-7117
Mailing address
788 N JEFFERSON ST, SUITE 300/ATTN. KAAREN BUTZEN, MILWAUKEE, WI 53202-3718
(414) 272-8950
(414) 272-0859
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
6391-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871974964
—
WI
Enumeration date
06/15/2015
Last updated
03/15/2017
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