Provider Demographics
NPI:1316358195
Name:SHELTON, ASHTON NICOLE (DC, CACCP, IBCLC)
Entity type:Individual
Prefix:
First Name:ASHTON
Middle Name:NICOLE
Last Name:SHELTON
Suffix:
Gender:F
Credentials:DC, CACCP, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 S SANGRE RD
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-1869
Mailing Address - Country:US
Mailing Address - Phone:405-612-1592
Mailing Address - Fax:405-372-9203
Practice Address - Street 1:1505 S SANGRE RD
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-1869
Practice Address - Country:US
Practice Address - Phone:405-372-9200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-14
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKL-315242174N00000X
OK4153111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No174N00000XOther Service ProvidersLactation Consultant, Non-RN