Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shandel Douglas, APN

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1649798455

Shandel Douglas, APN is a Nurse Practitioner in River Edge, New Jersey. Qualified in 2016, 10 years ago. Practices with Lifebulb LLC, a 94-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New Jersey.

Years since qualifying
10
Licensed in
NJ
In the registry since
2017
Specialties on file
2
What do these letters mean?
APN — Advanced Practice Nurse
The umbrella title some states use for nurse practitioners and other advanced practice nurses.

See every abbreviation used in this directory →

Practice location Address checks out

887 Kinderkamack Rd
River Edge, NJ 07661-2307
Phone: (201) 464-0860
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 26NJ00747600 (NJ)
Primary Care Nurse Practitioner Taxonomy 363LP2300X · Licence 26NJ00747600 (NJ)

Record details

NPI number1649798455
Entity typeIndividual (Type 1)
GenderFemale
Credentials APN
Sole proprietorNo
NPI enumeratedAugust 31, 2017
Last updated in NPPESDecember 31, 2025
Certification dateDecember 31, 2025
Mailing address887 Kinderkamack Rd, River Edge, NJ 07661-2307

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Lifebulb Llc — 94 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in River Edge