Radish, Krista Michele
Radish, Krista Michele is an individual health care provider with primary practice located at 835 S Main St , Oconto Falls WI 54154-1282. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Radish, Krista Michele can be contacted via phone (920) 496-4700.Contact Information
Primary practice address
835 S Main St
Oconto Falls WI 54154-1282
Phone: (920) 496-4700
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 13822-33 | Wisconsin |
Profile Details
| NPI number | 1669179552 |
|---|---|
| LBN Legal business name | Radish, Krista Michele |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 10th, 2023 |
| Last updated | Jan 18th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669179552 | NPPES |
| Wisconsin | MEDICAID | 100237377 |
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