Active NPI
Angela J Bebo, LPN
- Licensed Practical Nurse
- Marinette, WI
National Provider Identifier
1164575163
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- Practice address
- 334 Terrace Ave
Marinette, WI 54143-2711 - Phone
- (715) 735-8916
- NPI assigned
- Jan 21, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | WI | Primary |
Addresses
Primary practice location
334 Terrace Ave
Marinette, WI 54143-2711
Mailing address
3366 Wiggins Way
Green Bay, WI 54311
Phone (715) 330-0005
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 |
|---|---|---|---|
| 305899-031 | WI | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169337600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193184000000",
"number": "1164575163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3366 WIGGINS WAY",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "54311",
"telephone_number": "715-330-0005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "334 TERRACE AVE",
"city": "MARINETTE",
"state": "WI",
"postal_code": "541432711",
"telephone_number": "715-735-8916"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEBO",
"first_name": "ANGELA",
"middle_name": "J",
"name_prefix": "Mrs.",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-21",
"last_updated": "2007-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "WI",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marinette, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.