ELLEN M MELLICK (NPI# 1861476178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861476178 |
| Entity Type | Individual |
| Full Name | ELLEN M MELLICK |
| Credential | PNP |
| Practice Address |
212 11th St S La Crosse WI 54601-4116 |
| Practice Telephone | 6087919555 |
| Practice Fax Number | 6087919432 |
| Mailing Telephone | 6087919555 |
| Mailing Fax Number | 6087919432 |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
1395-033 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
212 11TH ST S |
| City | LA CROSSE |
| State | WI |
| Zip Code | 54601-4116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356346621 | Jeffrey R Court | Social Worker | 212 11th St S, La Crosse, WI 54601-4116 | 2005-06-14 |
| 1376010256 | Ashley Lee Sammann | Social Worker | 212 11th St S, La Crosse, WI 54601-4397 | 2018-10-29 |
| 1780168765 | Courtney Mcalister | Clinical Neuropsychologist | 212 11th St S, La Crosse, WI 54601-4397 | 2018-09-17 |
| 1376026831 | Nicole Marie Sobkowiak | Counselor | 212 11th St S, La Crosse, WI 54601-4397 | 2018-09-11 |
| 1407207764 | Clare Marie Lewandowski | Psychologist | 212 11th St S, La Crosse, WI 54601 | 2016-06-28 |
| 1922461813 | Jordan Daniel Urbanek | Psychiatry & Neurology | 212 11th St S, La Crosse, WI 54601-4397 | 2016-03-30 |
| 1962861716 | Heather K Roellig | Counselor | 212 11th St S, La Crosse, WI 54601-4397 | 2016-02-22 |
| 1487037826 | Christine A Dean | Social Worker | 212 11th St S, La Crosse, WI 54601-4397 | 2015-07-02 |
| 1841606142 | Reka Furedi | Psychiatry & Neurology | 212 11th St S, La Crosse, WI 54601-4397 | 2014-07-08 |
| 1013328889 | Melissa Lea Thielman | Social Worker | 212 11th St S, La Crosse, WI 54601-4397 | 2014-05-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891324265 | Meagan Mcrae | Student in an Organized Health Care Education/Training Program | 1725 State St., 4051 Health Science Center, La Crosse, WI 54601 | 2020-04-07 |
| 1255969671 | Erin Dingman | Student in an Organized Health Care Education/Training Program | 1751 State Street, 4051 Health Science Center, La Crosse, WI 54601 | 2020-03-31 |
| 1619505047 | Nicole Kay Lynch | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State St, La Crosse, WI 54601 | 2020-03-31 |
| 1174151757 | Jenna Sells | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1740818301 | Katie Irene Tahtinen | Student in an Organized Health Care Education/Training Program | Uwl- 4051 Health Science Center, 1725 State St., La Crosse, WI 54601 | 2020-03-30 |
| 1932737517 | Margaret May Grimm | Student in an Organized Health Care Education/Training Program | Univesity of Wisconsin-la Crosse, 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1831727312 | Matthew Timothy Axler | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1093340473 | Denise Stinson | Technician | 1311 Badger St, Apt 505, La Crosse, WI 54601 | 2020-03-06 |
| 1922632397 | Ibrahim Ahsan | Pharmacist | 1105 Wi-16, La Crosse, WI 54601 | 2020-02-25 |
| 1750913356 | Liza R Collins | Massage Therapist | 1415 State Wi 16, La Crosse, WI 54601 | 2020-02-11 |
| Find all providers in zip 54601 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235779240 | Conscious Practice, LLC | Nurse Practitioner | 119 19th St N, La Crosse, WI 54601-3724 | 2020-01-08 |
| 1396140398 | Monica Gorski | Nurse Practitioner | 505 King St Ste 218, La Crosse, WI 54601-4289 | 2014-11-03 |
| 1801402193 | Lisa Elizabeth Knudtson | Nurse Practitioner | 1900 South Ave, La Crosse, WI 54601-5467 | 2020-09-22 |
| 1861020406 | Micah Caleb Mcclung | Nurse Practitioner | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003422726 | Wisconsin Healthcare Family Practices and Behavioral Services LLC | Nurse Practitioner | 10721 W Capitol Dr Ste G103, Wauwatosa, WI 53222-1210 | 2020-09-17 |
| 1689292856 | Julianne Margaret John | Nurse Practitioner | 3237 S 16th St Ste 310, Milwaukee, WI 53215-4526 | 2020-07-13 |
| 1356968002 | Marisa Hiley | Nurse Practitioner | W129 N7055 Northfield Drive, Menomonee Falls, WI 53051 | 2020-06-29 |
| 1932726700 | Lauren Marie Skemp | Nurse Practitioner | 1960 Hyview Rd, Cuba City, WI 53807-9718 | 2020-06-28 |
| 1073152161 | Stephanie L Ruskell | Nurse Practitioner | 3805 Spring St Ste 240, Mount Pleasant, WI 53405-1667 | 2020-01-06 |
| 1558924811 | Sarah Kathryn Garven | Nurse Practitioner | 5000 West National Ave Rm 3119, Milwaukee, WI 53295-1000 | 2019-04-22 |
| 1104394535 | Therese Ann Alm | Nurse Practitioner | 383 Williamstowne Ste 101, Delafield, WI 53018-2332 | 2018-11-03 |
| 1477079242 | Aeron Rachel Adams | Nurse Practitioner | W10237 Lake Emily Rd, Fox Lake, WI 53933 | 2017-08-14 |
| 1518217280 | Jodi L Space | Nurse Practitioner | 5416 Everybodys Rd, Crandon, WI 54520-8627 | 2012-09-10 |
| 1942568498 | Mental Health for Women Medication Management, LLC | Nurse Practitioner | 1250 Femrite Dr Ste 205b, Monona, WI 53716-3787 | 2012-05-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.