Ellen L Anderson, RN
Individual provider Active NPI Registered Nurse · Oconomowoc, WI
NPI 1366768129 · NPPES record last updated Sep 27, 2012
Key facts
- NPI
- 1366768129
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 170758-030 (WI)
- Practice address
- N71W35536 Mapleton Lake Dr
Oconomowoc, WI 53066-1214 - Phone
- (262) 352-4107
- NPI assigned
- Apr 19, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 170758-030 | WI | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 170758-030 | WI | Yes |
Addresses
Primary practice location
N71W35536 Mapleton Lake Dr
Oconomowoc, WI 53066-1214
Mailing address
N71W35536 Mapleton Lake Dr
Oconomowoc, WI 53066-1214
Phone (262) 352-4107
Other providers in Oconomowoc, WI
- Kiah Allen
- Alliance Health Services S.C.
- Amanda Donath Psychological Services S C
- Julie Amtmann
- Alicia Marie Anderson
- Eric R Anderson
- Rebecca Pruella Anderson
- Andrew J. Schroettner, MDSC
- Alexander N Annis
- Apex Surgery Center SC
All providers in Oconomowoc, WI · Registered Nurse in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 27, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.