Healthcare Provider Details

I. General information

NPI: 1255463030
Provider Name (Legal Business Name): SHANNON L MALIKOWSKI CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 W EXCHANGE ST
AKRON OH
44302-1704
US

IV. Provider business mailing address

224 W EXCHANGE ST
AKRON OH
44302-1704
US

V. Phone/Fax

Practice location:
  • Phone: 330-344-6041
  • Fax: 330-344-6431
Mailing address:
  • Phone: 330-344-6041
  • Fax: 330-344-6431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberNP-06714
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: