=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700652807
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FRANCESCA RAEDEL FNP-BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/29/2023
-----------------------------------------------------
Last Update Date | 01/10/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2575 SPRUCE ST UNIT C
-----------------------------------------------------
City | BOULDER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80302-3806
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-741-8051
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 45 NORTHERN BLVD
-----------------------------------------------------
City | GREENVALE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11548-1346
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 646-350-4023
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 209.028833
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 209.028833
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------