ASHLEY MARIE RADKE


Address: 2500 N State St, Jackson, MS 39216-4500
Phone: 6019845236

ASHLEY MARIE RADKE (NPI# 1043797095) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1043797095
Entity Type Individual
Full Name ASHLEY MARIE RADKE
Credential CPNP-PC
Practice Address 2500 N State St
Jackson
MS 39216-4500
Mailing Address 802 Lakeland Dr Apt 307
Jackson
MS 39216-4624
Practice Telephone 6019845236
Mailing Telephone 6085720562
Enumeration Date 2018-07-23
Last Update Date 2018-07-23
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 2080P0006X Pediatrics
Specialization: Developmental – Behavioral Pediatrics
902731 MS Allopathic & Osteopathic Physicians
Y 363LP0200X Nurse Practitioner
Specialization: Pediatrics
902731 MS Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
MS MISSISSIPPI BOARD OF NURSING 902731 01

Office Location

Street Address 2500 N STATE ST
City JACKSON
State MS
Zip Code 39216-4500

Providers in the same location

NPI Name Taxonomy Address Enumeration
1477556231 University Ophthalmology Associates Ophthalmology 2500 N State St, Ste B329, Jackson, MS 39216-4500 2005-05-24
1396346607 Ashleigh Renfroe Hannah Nurse Practitioner 2500 N State St, Jackson, MS 39216-4500 2020-11-03
1770182438 Tara P. Carter Nurse Practitioner 2500 N State St, Jackson, MS 39216-4500 2020-10-22
1679189849 Raegan Wilson Registered Nurse 2500 N State St, Jackson, MS 39216-4500 2020-09-22
1851905095 Violet Maloba Awori Student in an Organized Health Care Education/Training Program 2500 N State St, Jackson, MS 39216-4500 2020-09-04
1295348639 Kassidy Voinche Pharmacist 2500 N State St, Jackson, MS 39216-4500 2020-08-25
1215549423 Brittney Leeann Williams Pharmacist 2500 N State St, Jackson, MS 39216-4500 2020-08-19
1912519364 Rashmi Verma Internal Medicine 2500 N State St, Jackson, MS 39216-4500 2020-08-18
1982215414 Anita Dhanrajani Pediatrics 2500 N State St, Jackson, MS 39216-4500 2020-08-10
1528676954 Nicholas Mcafee Psychologist 2500 N State St, Jackson, MS 39216-4500 2020-07-22
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1861011553 Ashley Melancon Prewitt Registered Nurse St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 2020-04-13
1194353391 Brianna Arrington Student in an Organized Health Care Education/Training Program Med/ Peds, 2500 N. State St., Jackson, MS 39216 2020-04-01
1720616485 Roshina Khalid Khan Student in an Organized Health Care Education/Training Program Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 2020-03-30
1275183550 Amanda Lynn Morellato Dentist Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 2019-09-18
1396305553 Abhishek Chhabra Student in an Organized Health Care Education/Training Program Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 2019-06-19
1427615996 Hometown Diagnostics Clinical Medical Laboratory Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 2019-05-21
1346807773 Shukundala C Smith Behavior Technician New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 2019-05-21
1063901098 G Eli Howell Md Pllc Plastic Surgery 971 Lakeland Dr Ste 225, Jackson, MS 39216 2018-05-04
1588168132 Caleb Zumbro Student in an Organized Health Care Education/Training Program Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 2018-03-20
1639677230 Walgreen Co Pharmacy 971 Lakeland Dr Ste 101, Jackson, MS 39216 2018-01-29
Find all providers in zip 39216

Taxonomy Information

Taxonomy Code 363LP0200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Pediatrics

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1881219129 Esther Epstein Nurse Practitioner 9 Dorchester Ct, Jackson, NJ 08527-2221 2020-06-12
1891233276 Optimum Healthcare Associates, Pa Nurse Practitioner 5350 Executive Pl, Suite 8, Jackson, MS 39206-4100 2017-02-06
1285778639 Felesia R Bowen Nurse Practitioner 17 Twin Oaks Ct, Jackson, NJ 08527-5359 2007-02-19
1972500536 Colleen Chadderton Nurse Practitioner 760 W Franklin St, Jackson, MI 49201-2048 2005-06-28
1942817366 Jenna Rhodig Nurse Practitioner 1418 E Michigan Ave, Jackson, MI 49202-3518 2020-09-29
1407466428 Alexandra Brittain Nurse Practitioner 19 Security Dr, Jackson, TN 38305-3626 2020-08-04
1184189680 Lyndi Nicole Ryan Nurse Practitioner 2500 N State St, Jackson, MS 39216-4500 2019-02-08
1487123923 Leah Lenaee Warner Nurse Practitioner 2500 N State St, Jackson, MS 39216-4500 2018-11-14
1356826044 Kaelyn Monroe Nurse Practitioner 2100 4th St, Jackson, MI 49203-4518 2018-09-27
1104300615 Emileigh S Williams Nurse Practitioner 2500 N State St, Jackson, MS 39216-4500 2018-09-20
Find all providers in JACKSON

Competitor

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City JACKSON
Zip Code 39216

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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