Individual
ANDREA SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
6828 BARDSTOWN RD, LOUISVILLE, KY 40291-3050
(502) 231-2020
(502) 736-4490
Mailing address
5855 RELIABLE PKWY, CHICAGO, IL 60686-0001
(502) 955-2020
(502) 736-4490
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1579DT
KY
152W00000X
Optometrist
18003225
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77001055
—
KY
Enumeration date
07/05/2005
Last updated
06/14/2010
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