SHUNTAK JERIDEAU NPI 1548578578

NPI Information

NPI: 1548578578
Provider Name: SHUNTAK JERIDEAU
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
1350 N WESTMORELAND RD
DALLAS, TX
ZIP 75211
Phone: (214) 330-0036
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Shuntak Jerideau is a psychiatric/mental health nurse practitioner in Dallas, TX. Shuntak Jerideau NPI is 1548578578. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1350 N WESTMORELAND RD
DALLAS, TX
ZIP 75211-654
Phone: (214) 330-0036

The NPI 1548578578 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/24/2010 and was last updated on 8/11/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163W00000X	Registered Nurse		734308	TEXAS	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	AP140554	TEXAS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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