MEDICARE: SHANTEL WILLIAMS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172A00000X	Driver		LA

General Provider Information

NPI Number	:	1720919384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANTEL WILLIAMS

Provider Business Mailing Address
First Line	:	119 RADCLIFFE DR
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70501-6464
Country	:	US
Telephone Number	:	337-780-1734
Fax Number	:

Provider Business Practice Location Address
First Line	:	119 RADCLIFFE DR
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70501-6464
Country	:	US
Telephone Number	:	337-780-1734
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2026
Last Update Date	:	05/25/2026

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Directions to “ SHANTEL WILLIAMS ” Practice Location

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