Healthcare Provider Details

I. General information

NPI: 1700652807
Provider Name (Legal Business Name): FRANCESCA RAEDEL FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2023
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2575 SPRUCE ST UNIT C
BOULDER CO
80302-3806
US

IV. Provider business mailing address

45 NORTHERN BLVD
GREENVALE NY
11548-1346
US

V. Phone/Fax

Practice location:
  • Phone: 720-741-8051
  • Fax: 720-306-7224
Mailing address:
  • Phone: 646-350-4023
  • Fax: 720-306-7224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209.028833
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209.028833
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: