Individual
MRS. SHANNON THERESA BAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
562 NJ - 23, POMPTON PLAINS, NJ 07444
(973) 616-5437
Mailing address
1092 MACOPIN RD, WEST MILFORD, NJ 07480-1509
(707) 479-2963
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
0024182216
VA
363LF0000X
Family Nurse Practitioner
Primary
26NJ14891300
NJ
Other
Enumeration date
08/25/2021
Last updated
08/16/2023
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