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

Mrs. Shanna Jay Dierker, FNP-BC

Individual provider Family Nurse Practitioner · NPI 1558728337

Mrs. Shanna Jay Dierker, FNP-BC is a Nurse Practitioner in Appleton, Wisconsin. Qualified in 2015, 11 years ago. Practices with Thedacare, Incorporated, a 654-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Iowa, Illinois, Missouri and Wisconsin.

Years since qualifying
11
Licensed in
IA, IL, MO, WI
In the registry since
2016
Specialties on file
5
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

3925 N Gateway Dr
Appleton, WI 54913-7863
Phone: (920) 702-6371
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 15817 (WI)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence A143402 (IA)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 209-014331 (IL)
Registered Nurse Taxonomy 163W00000X · Licence 2015032867 (MO)
Registered Nurse Taxonomy 163W00000X · Licence 041404031 (IL)

Record details

NPI number1558728337
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-BC
Sole proprietorNo
NPI enumeratedJanuary 25, 2016
Last updated in NPPESFebruary 19, 2025
Certification dateFebruary 19, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Thedacare, Incorporated — 654 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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