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NPI Code Detail

MEDICARE: SHANNON L MALIKOWSKI CNP

MEDICARE: SHANNON L MALIKOWSKI CNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LW0102XWomen's Health Nurse PractitionerNP-06714OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255463030
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON L MALIKOWSKI CNP
Provider Business Mailing Address
First Line : 500 S TRIMBLE RD
Second Line :
City : MANSFIELD
State : OH
Zip : 44906-4103
Country : US
Telephone Number : 419-756-6000
Fax Number : 419-756-1774
Provider Business Practice Location Address
First Line : 500 S TRIMBLE RD
Second Line :
City : MANSFIELD
State : OH
Zip : 44906-4103
Country : US
Telephone Number : 419-756-6000
Fax Number : 419-756-1774
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2007
Last Update Date : 07/08/2007

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