Provider Demographics
NPI:1043255375
Name:SHENTON, CAROL (ANP)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:SHENTON
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:438 RHONDA DR
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08332-4745
Mailing Address - Country:US
Mailing Address - Phone:856-327-4554
Mailing Address - Fax:
Practice Address - Street 1:70 COHANSEY ST
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:NJ
Practice Address - Zip Code:08302-1918
Practice Address - Country:US
Practice Address - Phone:856-451-4700
Practice Address - Fax:856-451-0029
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNN02769300164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ050643Medicare ID - Type Unspecified
NJP39126Medicare UPIN