| NPI | 1558133355 |
|---|---|
| Other Name | ELLIE RADEKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5020439) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11029037) |
| Enumeration Date | 2023-10-25 |
| Last Update Date | 2024-08-14 |