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

Shannon Jacklin, APNP

Individual provider Family Nurse Practitioner · NPI 1881464550

Shannon Jacklin, APNP is a Nurse Practitioner in West Bend, Wisconsin. Qualified in 2023, 3 years ago. Practices with Froedtert Andthe Medical College of Wisconsin Community Physicians Inc, a 1,255-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
3
Licensed in
WI
In the registry since
2024
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Practice location Address checks out

1700 W Paradise Dr
West Bend, WI 53095-9795
Phone: (262) 384-1555
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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 16053-33 (WI)

Record details

NPI number1881464550
Entity typeIndividual (Type 1)
GenderFemale
Credentials APNP
Sole proprietorNo
NPI enumeratedJanuary 4, 2024
Last updated in NPPESJanuary 13, 2025
Certification dateJanuary 13, 2025
Mailing address1700 W Paradise Dr, West Bend, WI 53095-9795

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Froedtert Andthe Medical College Of Wisconsin Community Physicians Inc — 1255 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in West Bend