Individual provider Active NPI

Jennifer Ottelien, APNP

  • Acute Care Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1801124904
Registry record updated Dec 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
3921-033 Issued in WI
Practice address
2901 W Kinnickinnic River Pkwy Ste 300
Milwaukee, WI 53215-3660
Phone
(414) 385-8700
Fax
(414) 385-8715
NPI assigned
Dec 1, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 3921-033 WI Primary

Addresses

Primary practice location

2901 W Kinnickinnic River Pkwy Ste 300
Milwaukee, WI 53215-3660

Mailing address

2901 W Kinnickinnic River Pkwy Ste 300
Milwaukee, WI 53215-3660

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3921-033WIMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alexander T. Hawkins MD, S.C. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1259625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259625600000",
    "number": "1801124904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 W KINNICKINNIC RIVER PKWY STE 300",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 W KINNICKINNIC RIVER PKWY STE 300",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153660",
            "telephone_number": "414-385-8700",
            "fax_number": "414-385-8715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTELIEN",
        "first_name": "JENNIFER",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-01",
        "last_updated": "2009-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WI",
            "license": "3921-033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2009; 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.