Provider Demographics
NPI:1073561205
Name:VAN ELLS, LYNN ALCY (RN, MS, APNP)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:ALCY
Last Name:VAN ELLS
Suffix:
Gender:F
Credentials:RN, MS, APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 S MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-5001
Mailing Address - Country:US
Mailing Address - Phone:608-233-6428
Mailing Address - Fax:
Practice Address - Street 1:15 S MEADOW LN
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-5001
Practice Address - Country:US
Practice Address - Phone:608-233-6428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIRN 89130-030163W00000X
WIAPNP 1023-033163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39405400Medicaid
WI38333900Medicaid
WI39405400Medicaid