Ann Elizabeth Dettlaff, APNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4360-033 Issued in WI

Practice address

250 W 6TH Ave
Oshkosh, WI 54902-5910

Phone

(920) 237-5000

Fax

(920) 237-5011

NPI assigned

Mar 16, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Ann Elizabeth Priest Former name

Electronic endpoints 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ann.priest.1@20410.direct.athenahealth.com

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.

• Thedacare Medical Center - Wild Rose, Inc

  • Critical Access Hospital
  • Wild Rose, WI
  • NPI 1043263999
  Medicare reassignment NPD
• Thedacare, Incorporated

  dba ThedaCare Physicians

  • Family Medicine Physician
  • New London, WI
  • NPI 1376656959
  Medicare reassignment

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

{
    "created_epoch": "1300233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1215236278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NEENAH CTR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563070",
            "telephone_number": "920-830-5900",
            "fax_number": "920-830-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 W 6TH AVE",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549025910",
            "telephone_number": "920-237-5000",
            "fax_number": "920-237-5011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 W. Association Dr.",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "54914",
            "country_code": "US",
            "telephone_number": "920-731-4354 x1003",
            "fax_number": "920-731-5021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DETTLAFF",
        "first_name": "ANN",
        "middle_name": "ELIZABETH",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-16",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "4360-033",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "4360-33",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100014463",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215236278",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aseverson155761@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "N1750 Lily Of The Valley Dr",
            "city": "Greenville",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549429044",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "N1750 Lily Of The Valley Dr",
            "city": "Greenville",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549429044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANN",
            "last_name": "PRIEST",
            "middle_name": "ELIZABETH",
            "credential": "APNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jemalene Dela Cruz, P.T
• Jennifer Delfosse
• Sara Amanda Demler, MS, CCC-SLP
• Leona F Dempsey, APNP, PH.D
• Cynthia Mary Dery, LPC
• Jenna L Devries, CRNA
• Amy Kathleen Dice, PMHNP
• Kristin Diedrich, PTA
• Digestive Healthcare Specialists, SC
• Kevin Dihel

• Nurse Practitioner in Oshkosh, WI
• Providers in Oshkosh, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.