Provider Demographics
NPI:1770267536
Name:NAULS, SHAWNTELLE
Entity type:Individual
Prefix:
First Name:SHAWNTELLE
Middle Name:
Last Name:NAULS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2935 WILLOW PL
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77707-5123
Mailing Address - Country:US
Mailing Address - Phone:409-245-2793
Mailing Address - Fax:
Practice Address - Street 1:2935 WILLOW PL
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77707-5123
Practice Address - Country:US
Practice Address - Phone:409-245-2793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3747AO65OX3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider