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General NPI Number Information
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NPI Number | 1841847050
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Entity Type | Individual
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Provider Name | STEPHANIE LYNN GALLANT-GOEDTEL FNP
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Gender | Female
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Dates
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Enumeration Date | 08/22/2019
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 1026 BROAD ST UNIT 18
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City | SHREWSBURY
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State | NJ
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Zip | 07702-4380
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Country | US
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Telephone | 732-542-0002
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Fax | 732-542-2992
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Provider Business Mailing Address
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Address Line | PO BOX 8519
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City | RED BANK
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State | NJ
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Zip | 07701-8519
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Country | US
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Telephone | 732-460-9840
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Fax | 732-460-9848
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ00949600
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License Number State | NJ
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