Healthcare Provider Details

I. General information

NPI: 1841646080
Provider Name (Legal Business Name): REBECCA L SOBANSKI APNP, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2016
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 W FLORIDA ST STE 315
MILWAUKEE WI
53204-1659
US

IV. Provider business mailing address

2112 E BENNETT AVE
MILWAUKEE WI
53207-2916
US

V. Phone/Fax

Practice location:
  • Phone: 414-348-8392
  • Fax: 414-296-8934
Mailing address:
  • Phone: 414-348-8392
  • Fax: 414-296-8934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number7047
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number7047-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: