Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1306569249 Individual Practitioner Female Practitioner

Shannon Gresham

Licensed Practical Nurse • Green Bay, WI

Professional Overview & Biography Verified Profile Summary

Shannon Gresham is a registered healthcare professional specializing in Licensed Practical Nurse in Green Bay, WI. Practice services are available at 2357 W MASON ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2357 W Mason St

Green Bay, WI 543034708

Telephone 1920265570
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Licensed Practical Nurse in Green Bay, WI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
44 Specialists

Practicing in Green Bay, WI (1775 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2022-09-26
Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

State License WI 320921-31

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Jennifer Strader

Counselor - Addiction (Substance Use Disorder)

NPI 1073496477
Roger Smith

Counselor - Addiction (Substance Use Disorder)

NPI 1114779451
Alyssa Baldwin

Licensed Practical Nurse

NPI 1144111535
Kelly Chrisman

Licensed Practical Nurse

NPI 1144148206
Jamie Theisen , SAC-IT

Counselor - Addiction (Substance Use Disorder)

NPI 1154994382

SACIT

Amy Retlick , SAC-IT

Counselor - Addiction (Substance Use Disorder)

NPI 1174290332

SACIT

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active September 26, 2022

NPI status registered as active in NPPES database

📍
Updated Practice Location September 26, 2022

Registered at 2357 W MASON ST, GREEN BAY, WI 543034708 (Tel: 1920265570)

📍
Updated Business Mailing Address September 26, 2022

Registered at 2357 W MASON ST, GREEN BAY, WI 543034708 (Tel: 1920265570)

👤
Provider Name / Credentials Updated September 26, 2022

Recorded as SHANNON GRESHAM

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 26, 2022

Licensed Practical Nurse (License #320921-31 in WI)

🟢
Initial NPI Registration & Enumeration September 26, 2022

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1306569249
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 26, 2022
Last Update: September 26, 2022
Sole Proprietor: No

Mailing Address

2357 W Mason St

Green Bay, WI 543034708

Phone: 1920265570

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.