Provider Demographics
NPI:1184222820
Name:SHOEMAKER, SIDNI BRIANNA (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:SIDNI
Middle Name:BRIANNA
Last Name:SHOEMAKER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 E ROWAN AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-1240
Mailing Address - Country:US
Mailing Address - Phone:509-489-2101
Mailing Address - Fax:509-252-1561
Practice Address - Street 1:235 E ROWAN AVE STE 102
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-1240
Practice Address - Country:US
Practice Address - Phone:509-489-2101
Practice Address - Fax:509-252-1561
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-14
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61103670363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner