Provider Demographics
NPI:1104703800
Name:SIMON-LEWIS, SHAUNTEL
Entity type:Individual
Prefix:
First Name:SHAUNTEL
Middle Name:
Last Name:SIMON-LEWIS
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 1:935 LAURENT ST
Mailing Address - Street 2:
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570-7289
Mailing Address - Country:US
Mailing Address - Phone:337-290-5896
Mailing Address - Fax:
Practice Address - Street 1:935 LAURENT ST
Practice Address - Street 2:
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-7289
Practice Address - Country:US
Practice Address - Phone:337-290-5896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)