Individual provider Active NPI

Robyn W Lauritsen, APNP

  • Family Nurse Practitioner
  • Appleton, WI
National Provider Identifier
1164045092
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10179-33 Issued in WI
Practice address
2575 E Evergreen Dr
Appleton, WI 54913-8910
Phone
(920) 404-2240
NPI assigned
May 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 10179-33 WI Primary
Registered Nurse 163W00000X 193403-30 WI

Addresses

Primary practice location

2575 E Evergreen Dr
Appleton, WI 54913-8910

Mailing address

2575 E Evergreen Dr
Appleton, WI 54913-8910
Phone (920) 404-2240

Other identifiers 1

IdentifierTypeStateIssuer
2020003466OtherAMERICAN NURSES CREDENTIALING CENTER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200730000299 WI Practitioner - Nurse Practitioner 2365867991 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
193403-30WIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc Current Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Jul 22, 2020 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Jul 22, 2020 Accepting new patients

Locations

1630 Commanche Ave
Green Bay, WI 54313
Phone (920) 430-4700

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1164045092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2575 E EVERGREEN DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138910",
            "telephone_number": "920-404-2240",
            "fax_number": "920-404-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 E EVERGREEN DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138910",
            "telephone_number": "920-404-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAURITSEN",
        "first_name": "ROBYN",
        "middle_name": "W",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-27",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "10179-33",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "193403-30",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN NURSES CREDENTIALING CENTER",
            "identifier": "2020003466",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.