Provider Demographics
NPI:1750092011
Name:RADULSKI, PAULA ELAINE (ATC, RN)
Entity type:Individual
Prefix:MS
First Name:PAULA
Middle Name:ELAINE
Last Name:RADULSKI
Suffix:
Gender:F
Credentials:ATC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 HAMPTON DR
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:VA
Mailing Address - Zip Code:22980-9600
Mailing Address - Country:US
Mailing Address - Phone:207-798-9135
Mailing Address - Fax:
Practice Address - Street 1:2055 HAMPTON DR
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:VA
Practice Address - Zip Code:22980-9600
Practice Address - Country:US
Practice Address - Phone:207-798-9135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001315836163W00000X
WA01260038662255A2300X
01260038662255A2300X
VA01260038662255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No163W00000XNursing Service ProvidersRegistered Nurse