Provider Demographics
NPI:1801508668
Name:GASTON, YANN SHEA STEPHANIE (RN BSN)
Entity type:Individual
Prefix:MISS
First Name:YANN SHEA STEPHANIE
Middle Name:
Last Name:GASTON
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 EDGERTON BLVD APT 105
Mailing Address - Street 2:
Mailing Address - City:AVENEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07001-2246
Mailing Address - Country:US
Mailing Address - Phone:718-309-0057
Mailing Address - Fax:
Practice Address - Street 1:345 EDGERTON BLVD APT 105
Practice Address - Street 2:
Practice Address - City:AVENEL
Practice Address - State:NJ
Practice Address - Zip Code:07001-2246
Practice Address - Country:US
Practice Address - Phone:718-309-0057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-22
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY847796163WH1000X, 163WH0200X
NJ26NR24609900163WI0500X, 163WR0400X, 163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation
No163WE0003XNursing Service ProvidersRegistered NurseEmergency