Provider Demographics
NPI:1073974341
Name:SHOEMAKER, RAQUEL (CPM, LM)
Entity Type:Individual
Prefix:
First Name:RAQUEL
Middle Name:
Last Name:SHOEMAKER
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2564 BRANCH ST APT 14
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-2851
Mailing Address - Country:US
Mailing Address - Phone:608-220-1065
Mailing Address - Fax:
Practice Address - Street 1:2564 BRANCH ST APT 14
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:WI
Practice Address - Zip Code:53562-2851
Practice Address - Country:US
Practice Address - Phone:608-220-1065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-15
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI114-94176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife