Healthcare Provider Details

I. General information

NPI: 1568358737
Provider Name (Legal Business Name): BALANCED BEGINNINGS LACTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 S SANGRE RD
STILLWATER OK
74074-1869
US

IV. Provider business mailing address

1505 S SANGRE RD
STILLWATER OK
74074-1869
US

V. Phone/Fax

Practice location:
  • Phone: 405-372-9200
  • Fax:
Mailing address:
  • Phone: 405-372-9200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State

VIII. Authorized Official

Name: DR. ASHTON NICOLE SHELTON
Title or Position: OWNER/LACTATION CONSULTANT
Credential: DC, CACCP, IBCLC
Phone: 405-293-1215