Provider Demographics
NPI:1013066737
Name:SHOEMAKER, ANYA (RN)
Entity Type:Individual
Prefix:
First Name:ANYA
Middle Name:
Last Name:SHOEMAKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S GREENFIELD RD
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-1501
Mailing Address - Country:US
Mailing Address - Phone:480-813-1770
Mailing Address - Fax:
Practice Address - Street 1:101 S GREENFIELD RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-1501
Practice Address - Country:US
Practice Address - Phone:480-813-1770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN101781163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool