Individual
MELISSA EBBEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP, FNP-BC, SANE-A
Contact information
Practice address
3325 W TWIN WILLOW CT, APPLETON, WI 54914-6648
(920) 450-3285
Mailing address
3325 W TWIN WILLOW CT, APPLETON, WI 54914-6648
(920) 450-3285
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60455694
WA
363L00000X
Nurse Practitioner
Primary
9631-33
WI
Other
Enumeration date
09/08/2019
Last updated
09/24/2019
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