Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Juanita Shawnta Outlaw, FNP-BC

Individual provider Family Nurse Practitioner · NPI 1083338198

Juanita Shawnta Outlaw, FNP-BC is a Nurse Practitioner in Smithfield, North Carolina. Qualified in 2014, 12 years ago. Practices with Mainstreet and Kidsstreet of North Carolina PLLC, a 76-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
12
Licensed in
NC
In the registry since
2022
Specialties on file
2
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

293 Bella Sq
Smithfield, NC 27577-8961
Phone: (252) 724-0192
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 197527 (NC)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 5017031 (NC)

Record details

NPI number1083338198
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-BC
Sole proprietorNo
NPI enumeratedOctober 3, 2022
Last updated in NPPESJanuary 3, 2023
Certification dateJanuary 3, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Mainstreet And Kidsstreet Of North Carolina Pllc — 76 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Smithfield