Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ellen Jean Ettlie, APNP

Individual provider Nurse Practitioner · NPI 1679128771

Ellen Jean Ettlie, APNP is a Nurse Practitioner in Janesville, Wisconsin. Qualified in 2019, 7 years ago. Practices with Mercy Health System Corporation, a 751-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
7
Licensed in
WI
In the registry since
2019
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Practice location Address checks out

3200 E Racine St
Janesville, WI 53546-2343
Phone: (608) 371-8000
Fax: (608) 371-8938
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 9343-33 (WI)

Record details

NPI number1679128771
Entity typeIndividual (Type 1)
GenderFemale
Credentials APNP
Sole proprietorNo
NPI enumeratedAugust 6, 2019
Last updated in NPPESNovember 11, 2020
Certification dateNovember 11, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Mercy Health System Corporation — 751 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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