Provider Demographics
NPI:1386306926
Name:SHOEMATE, JASMINE SHYANNE (CNA, CMAA)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:SHYANNE
Last Name:SHOEMATE
Suffix:
Gender:F
Credentials:CNA, CMAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 PATRICIA APT 212
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-5005
Mailing Address - Country:US
Mailing Address - Phone:210-906-1694
Mailing Address - Fax:
Practice Address - Street 1:1300 PATRICIA APT 212
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213-5005
Practice Address - Country:US
Practice Address - Phone:210-906-1694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-12
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNA0061009275376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty