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NPI Code Detail

MEDICARE: MRS. SHELBY SMOTHERMAN VASCOCU NP

MEDICARE: MRS. SHELBY SMOTHERMAN VASCOCU 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
1363LF0000XFamily Nurse PractitionerAP09366LA

General Provider Information

NPI Number : 1730619529
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHELBY SMOTHERMAN VASCOCU NP
Provider Business Mailing Address
First Line : 110 MOSES PL
Second Line :
City : WEST MONROE
State : LA
Zip : 71291-7841
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1616 WELLERMAN RD
Second Line :
City : WEST MONROE
State : LA
Zip : 71291-7427
Country : US
Telephone Number : 318-625-6250
Fax Number : 904-854-4878
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2017
Last Update Date : 07/01/2025

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