MEDICARE: REBECCA L SOBANSKI APNP, PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	7047-33	WI
2	363L00000X	Nurse Practitioner	7047	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841646080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA L SOBANSKI APNP, PMHNP-BC

Provider Business Mailing Address
First Line	:	1603 E OKLAHOMA AVE UNIT 70173
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53207-4604
Country	:	US
Telephone Number	:	414-348-8392
Fax Number	:	414-296-8934

Provider Business Practice Location Address
First Line	:	1433 N WATER ST FL 4
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53202-2557
Country	:	US
Telephone Number	:	414-348-8392
Fax Number	:	414-296-8934

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2016
Last Update Date	:	01/16/2026

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