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General NPI Number Information
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NPI Number | 1457148215
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Entity Type | Organization
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Legal Business Name | SHELLY CLAVIS, APN, DNP, LLC
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Dates
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Enumeration Date | 04/23/2025
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 337 ACADEMY TER
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City | LINDEN
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State | NJ
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Zip | 07036-5601
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Country | US
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Telephone | 201-500-6992
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Fax | 833-605-4359
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Provider Business Mailing Address
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Address Line | 337 ACADEMY TER
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City | LINDEN
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State | NJ
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Zip | 07036-5601
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Country | US
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Telephone | 201-500-6992
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Fax | 833-605-4359
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Authorized Official
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Title or Position | CREDENTIALING ASSOCIATE
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Name | EILIS PASKO
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Credential |
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Telephone | 201-500-6992
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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