Provider Demographics
NPI:1538431283
Name:BURTON, SHLANDA (BS,BS,CLE)
Entity type:Individual
Prefix:MS
First Name:SHLANDA
Middle Name:
Last Name:BURTON
Suffix:
Gender:F
Credentials:BS,BS,CLE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 MORGAN TRACE DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27127-6821
Mailing Address - Country:US
Mailing Address - Phone:336-995-8120
Mailing Address - Fax:
Practice Address - Street 1:1920 MORGAN TRACE DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27127-6821
Practice Address - Country:US
Practice Address - Phone:336-995-8120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-27
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101Y00000X, 133N00000X, 133NN1002X, 172V00000X, 174H00000X, 174N00000X, 175F00000X, 374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No172V00000XOther Service ProvidersCommunity Health Worker
No174H00000XOther Service ProvidersHealth Educator
No174N00000XOther Service ProvidersLactation Consultant, Non-RN
No175F00000XOther Service ProvidersNaturopath