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General NPI Number Information
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NPI Number | 1851486518
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Entity Type | Individual
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Provider Name | LAURIE ANN RADOJEVICH NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 05/05/2024
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Provider Practice Location Address
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Address Line | 7901 S 6TH ST
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City | OAK CREEK
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State | WI
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Zip | 53154-2010
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Country | US
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Telephone | 414-346-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 3304 W PUETZ RD
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City | FRANKLIN
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State | WI
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Zip | 53132-9354
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Country | US
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Telephone | 414-779-7788
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Fax |
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 1553-33
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1553-33
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License Number State | WI
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