Mary Elizabeth Allie, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

307129 Issued in WI

Practice address

407 Council St
Fort Atkinson, WI 53538-1619

Phone

(920) 723-7288

NPI assigned

Jan 26, 2022

Last updated

Jan 26, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Mary Elizabeth Roub Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1643155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1437801867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 COUNCIL ST",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381619",
            "telephone_number": "920-723-7288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 COUNCIL ST",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381619",
            "telephone_number": "920-723-7288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLIE",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-26",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "307129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "ROUB",
            "middle_name": "ELIZABETH",
            "prefix": "MS.",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Licensed Practical Nurse in Fort Atkinson, WI
• Providers in Fort Atkinson, WI by specialty
• Licensed Practical Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; 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.