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NPI Code Detail

MEDICARE: STEPHANIE A SHOEMAKER RN, FNP-C

MEDICARE: STEPHANIE A SHOEMAKER RN, FNP-C
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
1363LF0000XFamily Nurse PractitionerAP 60193374WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619108438
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE A SHOEMAKER RN, FNP-C
Provider Business Mailing Address
First Line : 2811 TIETON DR
Second Line :
City : YAKIMA
State : WA
Zip : 98902-3761
Country : US
Telephone Number : 509-575-8000
Fax Number :
Provider Business Practice Location Address
First Line : 4003 CREEKSIDE LOOP
Second Line :
City : YAKIMA
State : WA
Zip : 98908-3962
Country : US
Telephone Number : 509-248-3263
Fax Number : 509-225-2705
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2009
Last Update Date : 12/21/2021

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