Provider Demographics
NPI:1295523157
Name:LANCASTER, SHILOH (MS, RDN, CDPCC, LD)
Entity type:Individual
Prefix:
First Name:SHILOH
Middle Name:
Last Name:LANCASTER
Suffix:
Gender:
Credentials:MS, RDN, CDPCC, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1481 BYHALIA RD
Mailing Address - Street 2:
Mailing Address - City:HERNANDO
Mailing Address - State:MS
Mailing Address - Zip Code:38632-1003
Mailing Address - Country:US
Mailing Address - Phone:662-469-2906
Mailing Address - Fax:
Practice Address - Street 1:1481 BYHALIA RD
Practice Address - Street 2:
Practice Address - City:HERNANDO
Practice Address - State:MS
Practice Address - Zip Code:38632-1003
Practice Address - Country:US
Practice Address - Phone:662-469-2906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1517133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric