Ellen Maureen Latsch, CNP RNC

Primary specialty

Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X

License

521 Issued in WI

Practice address

2116 Craig Rd
Eau Claire, WI 54701-6149

Phone

(715) 858-4500

NPI assigned

Dec 6, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Ellen Maureen Fonville Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

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

{
    "created_epoch": "1196899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313366400000",
    "number": "1487837001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495703",
            "telephone_number": "715-387-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 CRAIG RD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016149",
            "telephone_number": "715-858-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATSCH",
        "first_name": "ELLEN",
        "middle_name": "MAUREEN",
        "credential": "CNP RNC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-06",
        "last_updated": "2011-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "WI",
            "license": "521",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R1692077",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "MN",
            "license": "LAT104292845",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43835900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "FONVILLE",
            "middle_name": "MAUREEN",
            "credential": "CNP RNC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Joshua H. Larson, M.D., PH.D.
• Kierstin Larson
• Noah Larson
• Richard Thomas Larson
• Darin C Lash, PA
• Latz Chiropractic LLC
• Jason Lau, PHARM D.
• Scott R Lau, BC, HIS, ACA
• Donna Sophia Lauer, RN
• Norbert B Laufenberg, LCSW

• Obstetrics & Gynecology Nurse Practitioner in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Obstetrics & Gynecology Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2011; 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.