Organization
HYDRATE YOUR WAY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOY SHANNON APRN, FNP (OWNER/CEO)
(862) 902-3094
Entity
Organization
Contact information
Practice address
10-12 SCOTT ST APT 2, NEWARK, NJ 07102-3493
(862) 902-3094
Mailing address
10-12 SCOTT ST APT 2, NEWARK, NJ 07102-3493
(862) 902-3094
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/10/2024
Last updated
04/19/2024
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