Individual
SHU-SHANNA PETA-GAYE DIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
718 TEANECK RD, TEANECK, NJ 07666-4245
(201) 833-3000
Mailing address
3 UNIVERSITY PLZ STE 205, HACKENSACK, NJ 07601-6208
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
26NJ01117100
NJ
363LG0600X
Gerontology Nurse Practitioner
26NJ01117100
NJ
Other
Enumeration date
05/25/2020
Last updated
04/11/2024
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