Provider Demographics
NPI:1326596255
Name:SHOEMAKE, CAITLIN (CRNP)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:SHOEMAKE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 INVERNESS CORS
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-3794
Mailing Address - Country:US
Mailing Address - Phone:205-980-0035
Mailing Address - Fax:
Practice Address - Street 1:1250 INVERNESS CORS
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-3794
Practice Address - Country:US
Practice Address - Phone:205-980-0035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-20
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-147378363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health