Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Kim Shackleford, FNTP

Individual provider Nutritionist · NPI 1376279513

MS. Kim Shackleford, FNTP is a Nutritionist in Raleigh, North Carolina. Practices as a sole proprietor. Registered with an NPI since 2022.

In the registry since
2022
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Practice location Address checks out

3830 Casey Leigh Ln
Raleigh, NC 27612-4258
Phone: (919) 427-5946
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nutritionist (primary) Taxonomy 133N00000X

Record details

NPI number1376279513
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNTP
Sole proprietorYes
NPI enumeratedJuly 29, 2022
Last updated in NPPESJuly 29, 2022
Certification dateJuly 29, 2022

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