Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | 201558 | NC |
N | 363LA2200X | Nurse Practitioner - Adult Health | 201558 | NC |
N | 363LC1500X | Nurse Practitioner - Community Health | 201558 | NC |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 201558 | NC |
N | 363LP0200X | Nurse Practitioner - Pediatrics | 201558 | NC |
N | 363LP1700X | Nurse Practitioner - Perinatal | 201558 | NC |
N | 363LP2300X | Nurse Practitioner - Primary Care | 201558 | NC |
N | 363LW0102X | Nurse Practitioner - Women's Health | 201558 | NC |
N | 363LX0001X | Nurse Practitioner - Obstetrics & Gynecology | 201558 | NC |
NPI | 1447312095 |
---|---|
Provider Name | Mrs. Shonda H Smitherman |
First Address | Yadkinville, NC 27055-0457 |
Second Address | Yadkinville, NC 27055-0457 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
ZF0000179 | (05) | NC |