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General NPI Number Information
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NPI Number | 1285227223
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Entity Type | Individual
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Provider Name | SHAKIRAH WILSON
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Gender | Female
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Dates
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Enumeration Date | 02/19/2021
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 3725 HILDANA RD
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City | SHAKER HEIGHTS
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State | OH
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Zip | 44120-5005
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Country | US
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Telephone | 216-855-3637
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Fax |
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Provider Business Mailing Address
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Address Line | 3725 HILDANA RD
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City | SHAKER HEIGHTS
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State | OH
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Zip | 44120-5005
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Country | US
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Telephone | 216-855-3637
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0039898
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN.402097
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 402097
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License Number State | OH
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