Provider Demographics
NPI:1558855973
Name:SHELTON, FALANDA LEE
Entity Type:Individual
Prefix:
First Name:FALANDA
Middle Name:LEE
Last Name:SHELTON
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 1:2302 PARKLAKE DR NE STE 670
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-2896
Mailing Address - Country:US
Mailing Address - Phone:470-299-4565
Mailing Address - Fax:470-299-4556
Practice Address - Street 1:2302 PARKLAKE DR NE STE 670
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-2896
Practice Address - Country:US
Practice Address - Phone:470-299-4565
Practice Address - Fax:470-299-4556
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-19
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies