Lanette Lynn Davis, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

14426-33 Issued in WI

Practice address

1516 S Green Bay Rd
Mount Pleasant, WI 53406-5789

Phone

(262) 900-1111

Fax

(262) 748-1605

NPI assigned

Sep 20, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lanette Lynn Nelson Former name

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lifepulse Wound & Home Healthcare Agency LLC

  • Home Health Agency
  • Racine, WI
  • NPI 1932827029
  Medicare reassignment NPD

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

{
    "created_epoch": "1695168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1336927243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 S GREEN BAY RD",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534065789",
            "telephone_number": "262-900-1111",
            "fax_number": "262-748-1605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 S GREEN BAY RD",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534065789",
            "telephone_number": "262-900-1111",
            "fax_number": "262-748-1605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "LANETTE",
        "middle_name": "LYNN",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-20",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "14426-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LANETTE",
            "last_name": "NELSON",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jonathan Richard Daniels, MD
• Nicholas A Darrow, PHARMD
• Sara Darvishiabyaneh
• Katherine Lynn Davies, MA/CCC-SLP
• James F Davis, RPH
• Sabrina Marie Davis, RBT
• Nashali De Leon Hernandez
• Demotris Dwayne De Valk Jr.
• De Witt Physical Therapy & Wellness LLC
• Dean Pain Management SC

• Psychiatric/Mental Health Nurse Practitioner in Mount Pleasant, WI
• Providers in Mount Pleasant, WI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.