Provider Demographics
NPI:1962959254
Name:RATKOVEC, LINDA (LPN)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:
Last Name:RATKOVEC
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21437 NORTHCAPE ST
Mailing Address - Street 2:
Mailing Address - City:UNION GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53182-9691
Mailing Address - Country:US
Mailing Address - Phone:262-880-0851
Mailing Address - Fax:262-514-3865
Practice Address - Street 1:21437 NORTHCAPE ST
Practice Address - Street 2:
Practice Address - City:UNION GROVE
Practice Address - State:WI
Practice Address - Zip Code:53182-9691
Practice Address - Country:US
Practice Address - Phone:262-880-0851
Practice Address - Fax:262-514-3865
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-05
Last Update Date:2016-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI314491-31164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI314491-31OtherLPN LICENSE