JESSICA E RADTKE (NPI# 1427421783) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427421783 |
| Entity Type | Individual |
| Full Name | JESSICA E RADTKE |
| Other Name | JESSICA E GRISWOLD |
| Credential | APNP |
| Practice Address |
2809 N Park Drive Ln Appleton WI 54911-1603 |
| Mailing Address |
122 E College Ave Appleton WI 54911-5794 |
| Practice Telephone | 9203804999 |
| Practice Fax Number | 9999999999 |
| Mailing Telephone | 9209963264 |
| Mailing Fax Number | 9208305970 |
| Enumeration Date | 2015-11-09 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 5693 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2500 E Capitol Dr, Appleton, WI 549118735 | 9208305879 |
| Street Address |
2809 N PARK DRIVE LN |
| City | APPLETON |
| State | WI |
| Zip Code | 54911-1603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205897279 | Laura Ann Madson | Physician Assistant | 2809 N Park Drive Ln, Appleton, WI 54911-1603 | 2006-03-30 |
| 1265940365 | Brent A Martin | Registered Nurse | 2809 N Park Drive Ln, Appleton, WI 54911-1603 | 2018-01-11 |
| 1083003826 | Michelle A Wilke | Counselor | 2809 N Park Drive Ln, Appleton, WI 54911-1603 | 2015-01-16 |
| 1336544972 | Darya Quandt | Counselor | 2809 N Park Drive Ln, Appleton, WI 54911-1603 | 2014-10-24 |
| 1972936789 | Stephanie R Smith | Physical Therapist | 2809 N Park Drive Ln, Appleton, WI 54911-1603 | 2013-08-15 |
| 1649588914 | Melissa N Miller | Physician Assistant | 2809 N Park Drive Ln, Appleton, WI 54911-1603 | 2010-09-20 |
| 1669646071 | Dia M Welch | Nurse Practitioner | 2809 N Park Drive Ln, Appleton, WI 54911-1603 | 2008-04-16 |
| 1962595249 | Bridget S Huenink | Nurse Practitioner | 2809 N Park Drive Ln, Appleton, WI 54911-1603 | 2006-10-01 |
| 1508959883 | Bonnie L Nickasch | Nurse Practitioner | 2809 N Park Drive Ln, Appleton, WI 54911-1603 | 2006-10-01 |
| 1376656959 | Thedacare, Incorporated | Family Medicine | 2809 N Park Drive Ln, Appleton, WI 54911-1603 | 2006-08-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912545633 | Brotherly Love, LLC | Day Training, Developmentally Disabled Services | 1513 E Frances St, Appleton, WI 54911 | 2019-12-12 |
| 1952952129 | Eagle Point Senior Living Inc | Assisted Living Facility | 995 East John Street, Appleton, WI 54911 | 2019-09-27 |
| 1619524766 | University Rx LLC | Pharmacy | 133 E College Ave, Appleton, WI 54911 | 2019-08-23 |
| 1174080063 | Shayla Russell | Counselor | Outagamie County Health and Human Services, 320 S. Walnut St., Appleton, WI 54911 | 2019-02-27 |
| 1871086645 | Megan Kilsdonk | Health Educator | 1604 N Meade St, Appleton, WI 54911 | 2018-06-07 |
| 1871085480 | Tanya Lynn Vickery | Social Worker | 410 S. Elm St., Appleton, WI 54911 | 2018-05-31 |
| 1013407501 | Teri G Metropulos | Counselor | 229 S. Morrison, Appleton, WI 54911 | 2018-05-10 |
| 1093211211 | Bonnie Anne Korytkowski | Student in an Organized Health Care Education/Training Program | 229 S. Morrison Street, Appleton, WI 54911 | 2018-04-05 |
| 1639673940 | Brett Follett | Psychologist | 401 S. Elm St., Appleton, WI 54911 | 2018-03-21 |
| 1700202892 | Brian Withrow | Counselor | 607 West 7th St., Appleton, WI 54911 | 2014-03-13 |
| Find all providers in zip 54911 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477070308 | Tamara Marie A Marshall | Nurse Practitioner | 5605 W Waterford Ln, Appleton, WI 54913-8438 | 2017-08-22 |
| 1871748418 | Tammy E Weyenberg | Nurse Practitioner | 3962 N Richmond St, Appleton, WI 54913-7153 | 2008-11-24 |
| 1396802823 | Ellen Pitsch | Nurse Practitioner | 2809 N. Park Drive Lane, Appleton, WI 54911 | 2007-01-03 |
| 1629024823 | Deborah S Colon | Nurse Practitioner | 30 S Behl St, Appleton, MN 56208-1616 | 2006-05-26 |
| 1871541342 | Kimberly Williams | Nurse Practitioner | 1616 N Casaloma Dr Ste 100, Appleton, WI 54913-8245 | 2006-05-05 |
| 1659363778 | Pam E Verkuilen | Nurse Practitioner | 5320 W Michaels Drive, Appleton, WI 54913 | 2005-08-16 |
| 1053918524 | Nicole Anne Vannoie | Nurse Practitioner | 2500 E Capitol Dr, Appleton, WI 54911-8735 | 2020-10-07 |
| 1306454053 | Samantha L Thiede | Nurse Practitioner | 1818 N Meade St, Appleton, WI 54911-3454 | 2020-07-20 |
| 1215556824 | Cheryl E Christensen | Nurse Practitioner | 2500 E Capitol Dr, Appleton, WI 54911-8735 | 2020-04-14 |
| 1902467731 | Danielle L Leick | Nurse Practitioner | 1818 N Meade St, Appleton, WI 54911-3454 | 2019-06-24 |
| Find all providers in APPLETON | ||||
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| 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.