Provider Demographics
NPI:1922040880
Name:SHOEMAKER, JOY R (CNP)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:R
Last Name:SHOEMAKER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 PIEDMONT LN
Mailing Address - Street 2:
Mailing Address - City:HEATH
Mailing Address - State:OH
Mailing Address - Zip Code:43056-1780
Mailing Address - Country:US
Mailing Address - Phone:740-323-3613
Mailing Address - Fax:
Practice Address - Street 1:920 N HAMILTON RD
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-1757
Practice Address - Country:US
Practice Address - Phone:614-293-2614
Practice Address - Fax:614-293-7001
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN199756 / NP07318363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner