Provider Demographics
NPI:1366160269
Name:NAGAHAMA, SHEENA (RN, APN,ACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:SHEENA
Middle Name:
Last Name:NAGAHAMA
Suffix:
Gender:F
Credentials:RN, APN,ACNP-BC
Other - Prefix:MS
Other - First Name:SHEENA
Other - Middle Name:
Other - Last Name:COPELAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN,APN,ACNP-BC
Mailing Address - Street 1:355 GRAND ST
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-4321
Mailing Address - Country:US
Mailing Address - Phone:201-915-2225
Mailing Address - Fax:
Practice Address - Street 1:355 GRAND ST
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-4321
Practice Address - Country:US
Practice Address - Phone:201-915-2225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-16
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01347700363LG0600X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology