Shackleford, Kim

Shackleford, Kim is an sole proprietor health care provider with primary practice located at 3830 Casey Leigh Ln , Raleigh NC 27612-4258. She recently has only one registered license in Dietary & Nutritional Service Providers / Nutritionist, which is considered as her primary health care specialty. Shackleford, Kim can be contacted via phone (919) 427-5946.

Contact Information

Primary practice address
3830 Casey Leigh Ln Raleigh NC 27612-4258
Phone: (919) 427-5946
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Nutritionist 133N00000X

Profile Details

NPI number 1376279513
LBN Legal business name Shackleford, Kim
Credentials FNTP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 29th, 2022
Last updated Jul 29th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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