SALLY JO SOBEL-RADKE RN NNP NPI 1396943627

NPI Information

NPI: 1396943627
Provider Name: SALLY JO SOBEL-RADKE, RN, NNP
Classification: Nurse Practitioner - 363LN0000X
Entity Type: Individual

Specialization: Neonatal

PECOS Registration: Yes

Address:
725 AMERICAN AVE 3RD FL NICU
PROHEALTH CARE MEDICAL ASSOCIATES INC.
WAUKESHA, WI
ZIP 53188
Phone: (262) 928-7276
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Sally Jo Sobel-radke, RN, NNP is a neonatal nurse practitioner in Waukesha, WI. Sally Jo Sobel-radke, RN, NNP NPI is 1396943627. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

725 AMERICAN AVE 3RD FL NICU
PROHEALTH CARE MEDICAL ASSOCIATES INC.
WAUKESHA, WI
ZIP 53188-031
Phone: (262) 928-7276

The NPI 1396943627 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/9/2007 and was last updated on 11/4/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WN0002X	Registered Nurse	Neonatal Intensive Care	180310-9	MINNESOTA	No
2	163WN0002X	Registered Nurse	Neonatal Intensive Care	96429-030	WISCONSIN	No
3	363LN0000X	Nurse Practitioner	Neonatal	1022	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	68375	MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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