Healthcare Provider Details

I. General information

NPI: 1750849386
Provider Name (Legal Business Name): SHEKILA THOMAS APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2019
Last Update Date: 06/04/2020
Certification Date: 06/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

932 S MAIN ST
PLEASANTVILLE NJ
08232-3646
US

IV. Provider business mailing address

1 N WHITE HORSE PIKE
HAMMONTON NJ
08037-1875
US

V. Phone/Fax

Practice location:
  • Phone: 609-383-0880
  • Fax: 609-383-0658
Mailing address:
  • Phone: 609-567-0200
  • Fax: 609-567-1169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00893700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: