Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shantonitt Wallace

Individual provider Contractor · NPI 1477262590

Shantonitt Wallace is a Contractor in Valdosta, Georgia. Registered with an NPI since 2022.

In the registry since
2022
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Practice location Address checks out

2209 Pulaski Cir
Valdosta, GA 31602-7312
Phone: (229) 618-0021
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Contractor (primary) Taxonomy 171W00000X

Record details

NPI number1477262590
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 17, 2022
Last updated in NPPESNovember 17, 2022
Certification dateNovember 17, 2022
Mailing address2209 Pulaski Cir, Valdosta, GA 31602-7312

Other providers in Valdosta