Provider Demographics
NPI:1891564225
Name:MEHLING, BABETTE MARIE (APNP)
Entity Type:Individual
Prefix:
First Name:BABETTE
Middle Name:MARIE
Last Name:MEHLING
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1513 PARK AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:WI
Mailing Address - Zip Code:53925-1793
Mailing Address - Country:US
Mailing Address - Phone:920-623-9611
Mailing Address - Fax:920-623-1787
Practice Address - Street 1:1513 PARK AVE FL 1
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:WI
Practice Address - Zip Code:53925-1793
Practice Address - Country:US
Practice Address - Phone:920-623-9611
Practice Address - Fax:920-623-1787
Is Sole Proprietor?:No
Enumeration Date:2023-12-27
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14834-33363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1891564225Medicaid