Individual provider Active NPI

Elizabeth Rebollar, BSN,RN

  • School Registered Nurse
  • Wilmot, WI
National Provider Identifier
1235043266
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
218938 Issued in WI
Practice address
11112 308TH Ave
Wilmot, WI 53192-7700
Phone
(262) 862-2351
Fax
(262) 862-6929
NPI assigned
Sep 29, 2026
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 218938 WI Primary

Addresses

Primary practice location

11112 308TH Ave
Wilmot, WI 53192-7700

Mailing address

11112 308TH Ave
Wilmot, WI 53192-7700
Phone (262) 862-2351

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": "1790640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1235043266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11112 308TH AVE",
            "city": "WILMOT",
            "state": "WI",
            "postal_code": "531927700",
            "telephone_number": "262-862-2351",
            "fax_number": "262-862-6929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11112 308TH AVE",
            "city": "WILMOT",
            "state": "WI",
            "postal_code": "531927700",
            "telephone_number": "262-862-2351",
            "fax_number": "262-862-6929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBOLLAR",
        "first_name": "ELIZABETH",
        "credential": "BSN,RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-29",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "WI",
            "license": "218938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmot, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.