Provider Demographics
NPI:1558324061
Name:SHOEMAKER, GLORIA LEE (RN, PHD)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:LEE
Last Name:SHOEMAKER
Suffix:
Gender:F
Credentials:RN, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1655 STURBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-8514
Mailing Address - Country:US
Mailing Address - Phone:412-367-1207
Mailing Address - Fax:
Practice Address - Street 1:401 SHADY AVE
Practice Address - Street 2:SUITE A 103
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-4409
Practice Address - Country:US
Practice Address - Phone:412-362-1280
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN186795L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse