Individual
SHANNON STOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 AIRPORT RD, LAKEWOOD, NJ 08701-5907
(732) 458-1700
Mailing address
508 EAGLE POINT DR, TOMS RIVER, NJ 08753-3354
(732) 330-3920
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ00814100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26NJ00814100
NJ STATE BOARD OF NURSING
NJ
Enumeration date
03/28/2018
Last updated
03/28/2018
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