Individual
CHARLOTTE R RADIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM, APRN
Contact information
Practice address
800 ROSE ST, LEXINGTON, KY 40536-2619
(859) 323-5931
(859) 257-7520
Mailing address
PO BOX 1430, PORTAGE, IN 46368-9230
(219) 763-8112
(219) 764-3251
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
09000259A
IN
367A00000X
Advanced Practice Midwife
29843
TN
367A00000X
Advanced Practice Midwife
Primary
3018119
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201278230
—
IN
Enumeration date
02/09/2015
Last updated
04/29/2024
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