Provider Demographics
NPI:1770920118
Name:TROELLER, REBECCA E (FNP-BC, APNP)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:E
Last Name:TROELLER
Suffix:
Gender:F
Credentials:FNP-BC, APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3710 57TH AVE
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53144-4820
Mailing Address - Country:US
Mailing Address - Phone:262-652-1474
Mailing Address - Fax:
Practice Address - Street 1:240 E HAMPTON RD
Practice Address - Street 2:
Practice Address - City:WHITEFISH BAY
Practice Address - State:WI
Practice Address - Zip Code:53217-5850
Practice Address - Country:US
Practice Address - Phone:414-962-7071
Practice Address - Fax:414-962-4241
Is Sole Proprietor?:No
Enumeration Date:2013-05-24
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5441-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily