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NPI Code Detail

MEDICARE: MRS. SHAKIRA DENISE ELLINGTON

MEDICARE: MRS. SHAKIRA DENISE ELLINGTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner26NJ15324600NJ

General Provider Information

NPI Number : 1174485841
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHAKIRA DENISE ELLINGTON
Provider Business Mailing Address
First Line : 520 HOMER TER
Second Line :
City : UNION
State : NJ
Zip : 07083-7323
Country : US
Telephone Number : 973-277-2230
Fax Number :
Provider Business Practice Location Address
First Line : 1 CLARA MAASS DR
Second Line :
City : BELLEVILLE
State : NJ
Zip : 07109-3550
Country : US
Telephone Number : 973-450-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2025
Last Update Date : 12/19/2025

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Directions to “ MRS. SHAKIRA DENISE ELLINGTON ” Practice Location

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