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Michelle Marie Radtke

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

PECOS Enrollment

This provider is enrolled in PECOS as MICHELLE RADTKE.

Based on the most recent information from CMS, provider Michelle Marie Radtke is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1821687385
Provider Type
Individual
Full Name
Radtke, Michelle Marie
Credential
APNP, FNP

Gender
Female
Sole Proprietor
No
Enumeration Date
1/11/2021
Last Updated
11/17/2022

Contact Information

Practice Location

130 2nd St, Neenah, WI 54956-2883

(920) 454-5007

Unlisted Fax

Mailing Location

130 2nd St, Neenah, WI 54956-2883

(920) 454-5007

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363L00000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 10664-33 Wisconsin

Michelle Marie Radtke

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Wolf, Emily M

Frank, Brenna Lee

Ver Voort, Nicole

Munson, Christine Ann

Klein, Jill N

Ottman, Ashley K

Branstrom, Kelly

Dailey, Kirsten E

Sagorac, Karla L

St Peter, Brandon M