MEDICARE: SHANA ANTOINETTE CONNER APN

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
1	363LA2200X	Adult Health Nurse Practitioner	26NJ15498600	NJ

General Provider Information

NPI Number	:	1386591840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANA ANTOINETTE CONNER APN

Provider Business Mailing Address
First Line	:	401 RIVENDELL WAY
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08817-2009
Country	:	US
Telephone Number	:	732-801-4765
Fax Number	:

Provider Business Practice Location Address
First Line	:	401 RIVENDELL WAY
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08817-2009
Country	:	US
Telephone Number	:	732-801-4765
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2026
Last Update Date	:	03/13/2026

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