Provider Demographics
NPI:1134402167
Name:SHELTON, CYNTHIA LYNN (NA)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:LYNN
Last Name:SHELTON
Suffix:
Gender:F
Credentials:NA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:454 MITCHELL LN
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37355-7845
Mailing Address - Country:US
Mailing Address - Phone:931-247-3107
Mailing Address - Fax:
Practice Address - Street 1:151 MAJORS BLVD
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:TN
Practice Address - Zip Code:37352
Practice Address - Country:US
Practice Address - Phone:934-759-4251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide