Healthcare Provider Details

I. General information

NPI: 1013376995
Provider Name (Legal Business Name): SHAWNESE DUREN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2016
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 BURRS RD STE A&B
WESTAMPTON NJ
08060-5517
US

IV. Provider business mailing address

817 FEDERAL ST OFC 6W58
CAMDEN NJ
08103-1539
US

V. Phone/Fax

Practice location:
  • Phone: 609-261-0240
  • Fax: 856-291-8880
Mailing address:
  • Phone: 856-583-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number26NJ15183600
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberSP15330
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: