Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Shanice S Kukuck, APNP

Individual provider Family Nurse Practitioner · NPI 1063151330

Dr. Shanice S Kukuck, APNP is a Family Nurse Practitioner in West Bend, Wisconsin. Licensed in Illinois and Wisconsin. Registered with an NPI since 2022.

Licensed in
IL, WI
In the registry since
2022
Specialties on file
3

Practice location Address checks out

1700 Paradise Dr
West Bend, WI 53095-9795
Phone: (262) 334-3451
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Nurse Practitioner (primary) Taxonomy 363LP0200X · Licence 209032039 (IL)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 209032039 (IL)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 11997-33 (WI)

Record details

NPI number1063151330
Entity typeIndividual (Type 1)
GenderFemale
Credentials APNP
Sole proprietorNo
NPI enumeratedJune 3, 2022
Last updated in NPPESJune 10, 2025
Certification dateJune 10, 2025

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