Individual
SHANNON NOVAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
258 BROAD ST STE 3, RED BANK, NJ 07701-2036
(732) 982-6128
(732) 383-8196
Mailing address
9 BRIDGEWATERS DR APT 23, OCEANPORT, NJ 07757-1159
(732) 982-6128
(732) 383-8196
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
11047425
FL
363LF0000X
Family Nurse Practitioner
Primary
26NJ155572200
NJ
Other
Enumeration date
05/07/2026
Last updated
05/11/2026
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