Provider Demographics
NPI:1992162507
Name:SHOENBERGER, EMILY (RN)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:SHOENBERGER
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 1:1344 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44504-1703
Mailing Address - Country:US
Mailing Address - Phone:330-742-2595
Mailing Address - Fax:330-742-2598
Practice Address - Street 1:4325 GREEN RD
Practice Address - Street 2:COTTAGE 3
Practice Address - City:HIGHLAND HILLS
Practice Address - State:OH
Practice Address - Zip Code:44128-4884
Practice Address - Country:US
Practice Address - Phone:330-467-7131
Practice Address - Fax:216-591-0223
Is Sole Proprietor?:No
Enumeration Date:2016-01-27
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN312643163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9321298OtherGROUP PTAN
OH1467421438OtherGROUP NPI
OH2488400Medicaid