Provider Demographics
NPI:1447312095
Name:SMITHERMAN, SHONDA H (RN FNP)
Entity type:Individual
Prefix:MRS
First Name:SHONDA
Middle Name:H
Last Name:SMITHERMAN
Suffix:
Gender:F
Credentials:RN FNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:217 E WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:YADKINVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27055-0457
Mailing Address - Country:US
Mailing Address - Phone:336-679-4203
Mailing Address - Fax:336-679-6358
Practice Address - Street 1:217 E WILLOW ST
Practice Address - Street 2:
Practice Address - City:YADKINVILLE
Practice Address - State:NC
Practice Address - Zip Code:27055-0457
Practice Address - Country:US
Practice Address - Phone:336-679-4203
Practice Address - Fax:336-679-6358
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC201558363LA2100X, 363LA2200X, 363LC1500X, 363LF0000X, 363LP0200X, 363LP1700X, 363LP2300X, 363LW0102X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LP1700XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPerinatal
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCZF0000179Medicaid