Active NPI
Melissa Ebben, APNP, FNP-BC, SANE-A
- Nurse Practitioner
- Appleton, WI
National Provider Identifier
1023667409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 9631-33
- Practice address
- 3325 W Twin Willow CT
Appleton, WI 54914-6648 - Phone
- (920) 450-3285
- NPI assigned
- Sep 8, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN60455694 | WA | |
| Nurse Practitioner | 363L00000X | 9631-33 | WI | Primary |
Addresses
Primary practice location
3325 W Twin Willow CT
Appleton, WI 54914-6648
Mailing address
3325 W Twin Willow CT
Appleton, WI 54914-6648
Phone (920) 450-3285
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN60455694 | WA | MD | Registered Nurse |
| 9631-33 | WI | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569283200000",
"number": "1023667409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3325 W TWIN WILLOW CT",
"city": "APPLETON",
"state": "WI",
"postal_code": "549146648",
"telephone_number": "920-450-3285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3325 W TWIN WILLOW CT",
"city": "APPLETON",
"state": "WI",
"postal_code": "549146648",
"telephone_number": "920-450-3285"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EBBEN",
"first_name": "MELISSA",
"credential": "APNP, FNP-BC, SANE-A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-08",
"last_updated": "2019-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WA",
"license": "RN60455694",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WI",
"license": "9631-33",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Appleton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.