Healthcare Provider Details

I. General information

NPI: 1194884346
Provider Name (Legal Business Name): JACQUELINE A SHOEMAKER RN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JACQUELINE A POST RN, FNP-BC

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 03/08/2021
Certification Date: 03/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3042 VALLEY AVE STE 106
WINCHESTER VA
22601-2669
US

IV. Provider business mailing address

220 CAMPUS BLVD STE 100
WINCHESTER VA
22601-2896
US

V. Phone/Fax

Practice location:
  • Phone: 540-686-7224
  • Fax: 540-450-8382
Mailing address:
  • Phone: 154-053-6510
  • Fax: 540-450-8382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001170503
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024168202
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: