Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Staci Jo Radtke, APNP

Individual provider Family Nurse Practitioner · NPI 1558662254

Staci Jo Radtke, APNP is a Nurse Practitioner in New London, Wisconsin. Qualified in 2010, 16 years ago. Practices with Thedacare, Incorporated, a 654-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
16
Licensed in
WI
In the registry since
2010
Specialties on file
2

Practice location Address checks out

1405 Mill St
New London, WI 54961-2155
Phone: (920) 531-2400
Fax: (920) 531-2466
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 744 S Webster Ave, Green Bay, WI 54301-3505 — (920) 433-3633
  • 100 County Road B, Shawano, WI 54166-7072 — (715) 526-7308

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 4264-33 (WI)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 4264 (WI)

Record details

NPI number1558662254
Entity typeIndividual (Type 1)
GenderFemale
Credentials APNP
Sole proprietorNo
NPI enumeratedNovember 11, 2010
Last updated in NPPESNovember 27, 2024
Certification dateNovember 27, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Thedacare, Incorporated — 654 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in New London