Provider Demographics
NPI:1619256278
Name:SHAMES, NANA A L (BSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:NANA
Middle Name:A L
Last Name:SHAMES
Suffix:
Gender:F
Credentials:BSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:HADDON HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08035-1623
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4 PLAZA DR
Practice Address - Street 2:SUITE 401
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2747
Practice Address - Country:US
Practice Address - Phone:856-270-4050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-12
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00504600364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health