Individual
STACIE DAWN SHOEMAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
156 E WALNUT AVE, EUPORA, MS 39744-2027
(731) 394-1145
Mailing address
3305 ATTALA ROAD 2269, FRENCH CAMP, MS 39745-9628
(254) 707-0990
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
1177371
TX
363LA2200X
Adult Health Nurse Practitioner
Primary
908040
MS
Other
Enumeration date
10/15/2024
Last updated
01/29/2026
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