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General NPI Number Information
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NPI Number | 1982345617
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Entity Type | Organization
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Legal Business Name | PRIORITY WOUND CARE LLC
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Dates
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Enumeration Date | 04/05/2022
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Last Update Date | 05/05/2026
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Provider Practice Location Address
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Address Line | 1431 S HIGHWAY 69
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City | NEDERLAND
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State | TX
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Zip | 77627-7841
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Country | US
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Telephone | 409-540-9418
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Fax | 866-397-8681
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Provider Business Mailing Address
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Address Line | 85 I-10 FRONTAGE RD SUITE 110
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City | BEAUMONT
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State | TX
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Zip | 77707
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Country | US
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Telephone | 409-853-1885
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Fax | 866-397-8681
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Authorized Official
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Title or Position | OWNER
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Name | SHALONDA MICHELLE JACOBS
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Credential | NP
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Telephone | 409-853-1885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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