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General NPI Number Information
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NPI Number | 1477832525
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Entity Type | Individual
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Provider Name | REBECCA LINTON RADKE NP-C
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Gender | Female
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Dates
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Enumeration Date | 08/08/2011
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Last Update Date | 01/10/2017
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Provider Practice Location Address
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Address Line | 993 JOHNSON FERRY RD BLDG C, STE 120
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City | ATLANTA
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State | GA
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Zip | 30342-1620
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Country | US
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Telephone | 404-790-7860
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Fax | 404-851-8673
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Provider Business Mailing Address
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Address Line | 993 JOHNSON FERRY RD BLDG C, STE 120
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City | ATLANTA
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State | GA
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Zip | 30342-1620
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Country | US
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Telephone | 404-790-7860
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Fax | 404-851-8673
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN116771
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License Number State | GA
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