SHANTONITT WALLACE NPI 1477262590

NPI Information

NPI: 1477262590
Provider Name: SHANTONITT WALLACE
Classification: Contractor - 171W00000X
Entity Type: Individual
Address:
2209 PULASKI CIR
VALDOSTA, GA
ZIP 31602
Phone: (229) 618-0021
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Shantonitt Wallace is a contractor in Valdosta, GA. The provider is a person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). Shantonitt Wallace NPI is 1477262590. 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:

2209 PULASKI CIR
VALDOSTA, GA
ZIP 31602-312
Phone: (229) 618-0021

The enumeration date for this NPI number is 11/17/2022 and was last updated on 11/17/2022.

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	171W00000X	Contractor				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: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

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