SAMUEL LAMONT JERIDEAU R.N. NPI 1790719748

NPI Information

NPI: 1790719748
Provider Name: SAMUEL LAMONT JERIDEAU, R.N.
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
1459 ACTON AVE
DUNCANVILLE, TX
ZIP 75137
Phone: (972) 780-0118
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Samuel Lamont Jerideau, R.N. is a family nurse practitioner in Duncanville, TX. Samuel Lamont Jerideau, R.N. NPI is 1790719748. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1459 ACTON AVE
DUNCANVILLE, TX
ZIP 75137-338
Phone: (972) 780-0118
Fax: (972) 780-0491

The enumeration date for this NPI number is 7/10/2006 and was last updated on 9/26/2011.

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	363LF0000X	Nurse Practitioner	Family	651668	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: 4/28/2024

NPI Synchronization or Removal

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