Provider Demographics
NPI:1073331146
Name:SHIMAMOTO, NAOMI (APRN-CNP, FNP-BC,)
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:SHIMAMOTO
Suffix:
Gender:F
Credentials:APRN-CNP, FNP-BC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 FUTURE DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-3481
Mailing Address - Country:US
Mailing Address - Phone:808-221-3179
Mailing Address - Fax:
Practice Address - Street 1:311 FUTURE DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213-3481
Practice Address - Country:US
Practice Address - Phone:808-221-3179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-28
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1176647363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily