Shannon Allen
Individual provider Active NPI Nurse Practitioner · Green Bay, WI
NPI 1609616341 · NPPES record last updated Feb 10, 2026
Key facts
- NPI
- 1609616341
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 15394 (WI)
- Practice address
- 503 S Monroe Ave
Green Bay, WI 54301-4017 - Phone
- (920) 436-8881
- NPI assigned
- May 30, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240930002515 | WI | Practitioner - Nurse Practitioner | 2466983630 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15394 | WI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baycare Clinic LLP | Current | Accepting new patients | |
| Baycare Clinic LLP | Current |
Accepting new patients | |
| Children'S Hospital of Wisconsin | Past | Accepting new patients | |
| Childrens Hospital of Wisconsin, Inc. | Past | Accepting new patients |
Locations
1035 Kepler Dr
Green Bay, WI 54311
2581 Development Dr
Green Bay, WI 54311
Phone (920) 347-0400
930 Maritime Dr
Manitowoc, WI 54220
Phone (920) 682-9121
719 Doctors Ct
Oshkosh, WI 54901
Phone (920) 235-0066
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 15394 | WI | Yes |
Addresses
Primary practice location
503 S Monroe Ave
Green Bay, WI 54301-4017
Mailing address
9000 W Wisconsin Ave
Milwaukee, WI 53226-4874
Other providers in Green Bay, WI
- Ernest J Allard
- Allcare Dental & Dentures of Wi PC
- Heather Riessland Allen
- Kendra Allen
- Lisa Leanne Allen
- Steven Charles Allen
- Candena L Allenbrand
- Allouez Family Dental Center SC
- Madeline C Almond
- Almost Family Personal Care, LLC
All providers in Green Bay, WI · Nurse Practitioner in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.