Provider Demographics
NPI:1285164608
Name:BURNHAM, SHEILAH EVELYN (IBCLC)
Entity type:Individual
Prefix:
First Name:SHEILAH
Middle Name:EVELYN
Last Name:BURNHAM
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1258 JERSEY RD
Mailing Address - Street 2:
Mailing Address - City:EAST MEREDITH
Mailing Address - State:NY
Mailing Address - Zip Code:13757-1190
Mailing Address - Country:US
Mailing Address - Phone:607-287-8156
Mailing Address - Fax:
Practice Address - Street 1:1258 JERSEY RD
Practice Address - Street 2:
Practice Address - City:EAST MEREDITH
Practice Address - State:NY
Practice Address - Zip Code:13757-1190
Practice Address - Country:US
Practice Address - Phone:607-287-8156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYL-49906174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN