Provider Demographics
NPI:1336847870
Name:SHOEMO, ANITA JOY (CERTIFIED PHLEBOTOMY)
Entity Type:Individual
Prefix:MS
First Name:ANITA
Middle Name:JOY
Last Name:SHOEMO
Suffix:
Gender:F
Credentials:CERTIFIED PHLEBOTOMY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 TIMBER CREEK LN SW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-5466
Mailing Address - Country:US
Mailing Address - Phone:770-871-1226
Mailing Address - Fax:
Practice Address - Street 1:161 TIMBER CREEK LN SW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-5466
Practice Address - Country:US
Practice Address - Phone:770-871-1226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHN21214258246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy