Provider Demographics
NPI:1699318113
Name:SHIELDS BURNS, CHELSEA VICTORIA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:VICTORIA
Last Name:SHIELDS BURNS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 BRANDON CT
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-3507
Mailing Address - Country:US
Mailing Address - Phone:434-548-4515
Mailing Address - Fax:
Practice Address - Street 1:625 S VAN BUREN RD
Practice Address - Street 2:
Practice Address - City:EDEN
Practice Address - State:NC
Practice Address - Zip Code:27288-5319
Practice Address - Country:US
Practice Address - Phone:434-548-4515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-28
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202210628183500000X
NC28024183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0202210628OtherVIRGINIA BOARD OF PHARMACY