MEDICARE: JENTELL SHONTA CALAIS

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	343900000X	Non-emergency Medical Transport (VAN)	010118569	LA

General Provider Information

NPI Number	:	1134052327
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENTELL SHONTA CALAIS

Provider Business Mailing Address
First Line	:	307 DEER MEADOW BLVD
Second Line	:
City	:	BROUSSARD
State	:	LA
Zip	:	70518-5229
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	307 DEER MEADOW BLVD
Second Line	:
City	:	BROUSSARD
State	:	LA
Zip	:	70518-5229
Country	:	US
Telephone Number	:	337-849-0334
Fax Number	:

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

Provider Enumeration Date	:	06/05/2026
Last Update Date	:	06/05/2026

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Directions to “ JENTELL SHONTA CALAIS ” Practice Location

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