Individual provider Active NPI

Rebecca Delain, RN, BSN,CDE

  • Diabetes Educator Registered Nurse
  • Green Bay, WI
National Provider Identifier
1255876462
Registry record updated Dec 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diabetes Educator Registered NurseTaxonomy code 163WD0400X
License
85441 Issued in WI
Practice address
616 Aurora Dr
Green Bay, WI 54302-4871
Phone
(920) 465-0583
NPI assigned
Dec 23, 2016
Last updated
Dec 23, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered Nurse 163WD0400X 85441 WI Primary

Addresses

Primary practice location

616 Aurora Dr
Green Bay, WI 54302-4871

Mailing address

616 Aurora Dr
Green Bay, WI 54302-4871
Phone (920) 465-0583

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
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
85441WIMDDiabetes Educator Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1482451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482451200000",
    "number": "1255876462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 AURORA DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543024871",
            "telephone_number": "920-465-0583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 AURORA DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543024871",
            "telephone_number": "920-465-0583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELAIN",
        "first_name": "REBECCA",
        "credential": "RN, BSN,CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-23",
        "last_updated": "2016-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "WI",
            "license": "85441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.