Individual provider Active NPI

Jessalynn Hietpas

  • Registered Nurse
  • Appleton, WI
National Provider Identifier
1093628208
Registry record updated Sep 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
163788-30 Issued in WI
Practice address
131 E Washington St Ste 1a
Appleton, WI 54911-5447
Phone
(920) 419-7302
NPI assigned
Sep 28, 2026
Last updated
Sep 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 163788-30 WI Primary

Addresses

Primary practice location

131 E Washington St Ste 1a
Appleton, WI 54911-5447

Mailing address

2305 W Capitol Dr
Appleton, WI 54914-6831

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1790553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790553600000",
    "number": "1093628208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2305 W CAPITOL DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549146831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 E WASHINGTON ST STE 1A",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115447",
            "telephone_number": "920-419-7302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIETPAS",
        "first_name": "JESSALYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-28",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "163788-30",
            "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 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.