Provider Demographics
NPI:1629791686
Name:CAVALIER, SHAWN A (RN)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:A
Last Name:CAVALIER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-1723
Mailing Address - Country:US
Mailing Address - Phone:856-419-7838
Mailing Address - Fax:
Practice Address - Street 1:317 E BROAD ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-1723
Practice Address - Country:US
Practice Address - Phone:856-419-7838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN682041163W00000X
NJ26NR18039500163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse