Healthcare Provider Details

I. General information

NPI: 1124268529
Provider Name (Legal Business Name): SHAUNDE JERMAINE SMITH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2009
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 HIGHWAY 327 E
SILSBEE TX
77656-5005
US

IV. Provider business mailing address

711 HIGHWAY 327 E
SILSBEE TX
77656-5005
US

V. Phone/Fax

Practice location:
  • Phone: 409-385-0556
  • Fax:
Mailing address:
  • Phone: 409-385-9037
  • Fax: 855-538-3243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number656857
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP117554
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP117554
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number656857
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: