Ann T Derge, BSN, RN-C, APNP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

1014-033 Issued in WI

Practice address

1537 Park PL
Ste 200
Green Bay, WI 54304-1974

Phone

(920) 498-8650

Fax

(920) 498-0945

NPI assigned

Sep 20, 2006

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 identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1952409732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1537 PARK PL",
            "address_2": "STE 200",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543041974",
            "telephone_number": "920-498-8650",
            "fax_number": "920-498-0945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1537 PARK PL",
            "address_2": "STE 200",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543041974",
            "telephone_number": "920-498-8650",
            "fax_number": "920-498-0945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERGE",
        "first_name": "ANN",
        "middle_name": "T",
        "credential": "BSN, RN-C, APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "WI",
            "license": "1014-033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "000207365",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1014-033",
            "identifier": "STATE LICENSE",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "82393-030",
            "identifier": "STATE LICENSE",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany Jaye Depietropaolo, D-PT
• Kristin R Depouw, AUD
• Jane E Deprey, SAC-IT
• Melissa A Dercks, APNP
• Danna Anne Derenne, APNP
• Dermatology Clinic S.C.
• Paul Herbert Dernehl, DDS
• Ahmet Dervish, MD
• Amy Des Forge, MS, LPC
• Ashley Desanctis, BCBA

• Women's Health Nurse Practitioner in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Women's Health Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.