Provider Demographics
NPI:1720821630
Name:SHOEMAKER, JAMIE LYNN (ACNP-AG)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:LYNN
Last Name:SHOEMAKER
Suffix:
Gender:F
Credentials:ACNP-AG
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:LYNN
Other - Last Name:ONORATI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5361 MUNFORD GILTEDGE RD
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:TN
Mailing Address - Zip Code:38011-6035
Mailing Address - Country:US
Mailing Address - Phone:901-304-3873
Mailing Address - Fax:
Practice Address - Street 1:5361 MUNFORD GILTEDGE RD
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:TN
Practice Address - Zip Code:38011-6035
Practice Address - Country:US
Practice Address - Phone:901-304-3873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN36400207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine