Individual
SHANNON MARIE ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
140 FRANKLIN TPKE, WALDWICK, NJ 07463-1847
(201) 447-3603
Mailing address
48 3RD ST, PEQUANNOCK, NJ 07440-1219
(973) 349-4009
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
26NR18744700
NJ
363LF0000X
Family Nurse Practitioner
Primary
26NJ01164000
NJ
Other
Enumeration date
03/09/2021
Last updated
06/14/2021
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