Healthcare Provider Details

I. General information

NPI: 1194629196
Provider Name (Legal Business Name): STEFANI PIERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 RANDI WAY
NEPTUNE NJ
07753-3559
US

IV. Provider business mailing address

3 RANDI WAY
NEPTUNE NJ
07753-3559
US

V. Phone/Fax

Practice location:
  • Phone: 732-977-9774
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number26NJ15666000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: