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

Shannon Johnson

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1184568123

Shannon Johnson is a Nurse Practitioner in West Bend, Wisconsin. Qualified in 2022, 4 years ago. Practices as a sole proprietor. Licensed in Wisconsin.

Years since qualifying
4
Licensed in
WI
In the registry since
2026

Practice location Address checks out

111 E Washington St
West Bend, WI 53095-2571
Phone: (262) 338-2717
Show map & directions

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

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 18294-33 (WI)

Record details

NPI number1184568123
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 20, 2026
Last updated in NPPESApril 20, 2026
Certification dateMarch 23, 2026
Mailing address5761 N River Forest Dr, Glendale, WI 53209-4521

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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