Healthcare Provider Details

I. General information

NPI: 1861274490
Provider Name (Legal Business Name): KRISTINA OLEGOVNA SHKOLNIK PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2023
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35279 VINE ST
WILLOWICK OH
44095-3140
US

IV. Provider business mailing address

35279 VINE ST
WILLOWICK OH
44095-3140
US

V. Phone/Fax

Practice location:
  • Phone: 440-918-0700
  • Fax: 440-918-1539
Mailing address:
  • Phone: 440-918-0700
  • Fax: 440-918-1539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number60454
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS67136
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPU10360
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03443767
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number33770
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: