Provider Demographics
NPI:1619756442
Name:GOODEN, SHENELLE K (APN)
Entity type:Individual
Prefix:
First Name:SHENELLE
Middle Name:K
Last Name:GOODEN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:331 NEWMAN SPRINGS RD STE 220
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-5792
Mailing Address - Country:US
Mailing Address - Phone:732-807-0877
Mailing Address - Fax:201-751-1680
Practice Address - Street 1:1 METRO BLVD
Practice Address - Street 2:STE 2D
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07014
Practice Address - Country:US
Practice Address - Phone:973-230-6666
Practice Address - Fax:973-230-6686
Is Sole Proprietor?:No
Enumeration Date:2023-09-21
Last Update Date:2025-11-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ14933400363LF0000X
NY352829363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily