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NPI Code Detail

MEDICARE: SHIESHA MALIK OLIVER-WACHIRA RN

MEDICARE: SHIESHA MALIK OLIVER-WACHIRA RN
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
1163W00000XRegistered NurseRN357803OH

General Provider Information

NPI Number : 1881983245
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHIESHA MALIK OLIVER-WACHIRA RN
Provider Business Mailing Address
First Line : 3929 ROCKY RIVER DR
Second Line :
City : CLEVELAND
State : OH
Zip : 44111-4153
Country : US
Telephone Number : 216-252-5800
Fax Number :
Provider Business Practice Location Address
First Line : 3929 ROCKY RIVER DR
Second Line :
City : CLEVELAND
State : OH
Zip : 44111-4153
Country : US
Telephone Number : 216-252-5800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2011
Last Update Date : 01/31/2022

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