Provider Demographics
NPI:1245726223
Name:STRUMEIER, SHANAH MARISA (NP)
Entity type:Individual
Prefix:MS
First Name:SHANAH
Middle Name:MARISA
Last Name:STRUMEIER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 416457
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-6457
Mailing Address - Country:US
Mailing Address - Phone:443-621-7358
Mailing Address - Fax:
Practice Address - Street 1:100 MADISON AVE # GAGNON C
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6136
Practice Address - Country:US
Practice Address - Phone:973-971-4179
Practice Address - Fax:973-898-1600
Is Sole Proprietor?:No
Enumeration Date:2018-07-02
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01303200363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner