Individual provider Active NPI

Jeanette Q Allen, BSN, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Waukesha, WI
National Provider Identifier
1669035721
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
15683-33 Issued in WI
Practice address
2021 Cardinal Dr
Waukesha, WI 53186-2693
Phone
(414) 795-7352
NPI assigned
Apr 15, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 15683-33 WI Primary

Addresses

Primary practice location

2021 Cardinal Dr
Waukesha, WI 53186-2693

Mailing address

2021 Cardinal Dr
Waukesha, WI 53186-2693
Phone (414) 795-7352

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251006001976 WI Practitioner - Nurse Practitioner 5092211250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wi SHMH SCGroup PAC ID 7012455462, 9 clinicians

Practice addresses (Care Compare)

18740 W Bluemound Rd
Brookfield, WI 53045-2936
Phone (773) 332-7539

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
15683-33WIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wi SHMH SC CurrentSince Nov 1, 2025 Accepting new patients
Happy Living Intellectual Clinic Psychiatric/Mental Health Current Accepting new patients

Locations

5454 Fargo Ave
Skokie, IL 60077
Phone (847) 674-5454

18740 W Bluemound Rd
Brookfield, WI 53045
Phone (262) 782-0230

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1669035721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 CARDINAL DR",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531862693",
            "telephone_number": "414-795-7352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 CARDINAL DR",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531862693",
            "telephone_number": "414-795-7352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "JEANETTE",
        "middle_name": "Q",
        "name_prefix": "Mrs.",
        "credential": "BSN, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-15",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "15683-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.