Individual provider · Type 1 NPI

Shanna Jay Dierker, FNP-BC

Family Nurse Practitioner · Appleton, WI

NPI number 1558728337 Active

Practice location

3925 N Gateway Dr
Appleton, WI 54913-7863

Mailing address

3 Neenah Ctr
Neenah, WI 54956-3070

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner 363LF0000XA143402 (IA)
Family Nurse Practitioner 363LF0000X209-014331 (IL)
Family Nurse Practitioner Primary 363LF0000X15817 (WI)
Registered Nurse 163W00000X2015032867 (MO)
Registered Nurse 163W00000X041404031 (IL)

Family Nurse Practitioner: Definition to come...

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About NPI 1558728337

Shanna Jay Dierker, FNP-BC's National Provider Identifier is 1558728337, issued on Jan 25, 2016. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Appleton, WI. The record was last updated on Feb 19, 2025.