Healthcare Provider Details

I. General information

NPI: 1154235901
Provider Name (Legal Business Name): SHAWANA MONIQUE WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2449 JENNINGS RD APT A
AUGUSTA GA
30906-5416
US

IV. Provider business mailing address

2449 JENNINGS RD APT A
AUGUSTA GA
30906-5416
US

V. Phone/Fax

Practice location:
  • Phone: 803-508-2280
  • Fax:
Mailing address:
  • Phone: 803-508-2280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2278H0200X
TaxonomyHome Health Certified Respiratory Therapist
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: