Provider Demographics
NPI:1336910140
Name:ESLICK, ANNA (APNP)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:ESLICK
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:MESSEROLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:366 KASSANDER WAY
Mailing Address - Street 2:
Mailing Address - City:OREGON
Mailing Address - State:WI
Mailing Address - Zip Code:53575-9104
Mailing Address - Country:US
Mailing Address - Phone:402-980-6790
Mailing Address - Fax:
Practice Address - Street 1:752 N HIGH POINT RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53717-2236
Practice Address - Country:US
Practice Address - Phone:608-824-4000
Practice Address - Fax:608-824-4104
Is Sole Proprietor?:No
Enumeration Date:2024-01-10
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14332363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1336910140Medicaid