Yann Shea Stephanie Gaston, RN BSN

Individual provider Active NPI Home Health Registered Nurse · Avenel, NJ

NPI 1801508668 · NPPES record last updated Dec 22, 2022

Key facts

NPI
1801508668
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Registered Nurse 163WH0200X
License
847796 (NY)
Practice address
345 Edgerton Blvd Apt 105
Avenel, NJ 07001-2246
Phone
(718) 309-0057
NPI assigned
Dec 22, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
26NR24609900NJMDEmergency Registered Nurse
847796NYMDHospice Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice Registered Nurse 163WH1000X 847796 NY
Infusion Therapy Registered Nurse 163WI0500X 26NR24609900 NJ
Rehabilitation Registered Nurse 163WR0400X 26NR24609900 NJ
Home Health Registered Nurse 163WH0200X 847796 NY Yes
Emergency Registered Nurse 163WE0003X 26NR24609900 NJ

Addresses

Primary practice location

345 Edgerton Blvd Apt 105
Avenel, NJ 07001-2246

Mailing address

345 Edgerton Blvd Apt 105
Avenel, NJ 07001-2246
Phone (718) 309-0057

Other providers in Avenel, NJ

All providers in Avenel, NJ · Home Health Registered Nurse in New Jersey

Sources for this page

Verify at the official NPI Registry.