MEDICARE: VERMICKER SMITH NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	774391	TX

General Provider Information

NPI Number	:	1629331392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VERMICKER SMITH NP

Provider Business Mailing Address
First Line	:	1500 UNIVERSITY DR E STE 100
Second Line	:
City	:	COLLEGE STATION
State	:	TX
Zip	:	77840-2600
Country	:	US
Telephone Number	:	979-596-5852
Fax Number	:

Provider Business Practice Location Address
First Line	:	3370 S TEXAS AVE
Second Line	:
City	:	BRYAN
State	:	TX
Zip	:	77802-3127
Country	:	US
Telephone Number	:	979-595-1700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2012
Last Update Date	:	06/23/2026

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Directions to “ VERMICKER SMITH NP” Practice Location

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