Healthcare Provider Details

I. General information

NPI: 1447312095
Provider Name (Legal Business Name): SHONDA H SMITHERMAN RN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 E WILLOW ST
YADKINVILLE NC
27055-0457
US

IV. Provider business mailing address

217 E WILLOW ST
YADKINVILLE NC
27055-0457
US

V. Phone/Fax

Practice location:
  • Phone: 336-679-4203
  • Fax: 336-679-6358
Mailing address:
  • Phone: 336-679-4203
  • Fax: 336-679-6358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number201558
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number201558
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License Number201558
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201558
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number201558
License Number StateNC
# 6
Primary TaxonomyN
Taxonomy Code363LP1700X
TaxonomyPerinatal Nurse Practitioner
License Number201558
License Number StateNC
# 7
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number201558
License Number StateNC
# 8
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number201558
License Number StateNC
# 9
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number201558
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: