Provider Demographics
NPI:1902961121
Name:SIKORSKI, SHANNON M (CNP)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:M
Last Name:SIKORSKI
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:
Other - Last Name:RYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:1 PERKINS SQ
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44308-1063
Mailing Address - Country:US
Mailing Address - Phone:330-543-8730
Mailing Address - Fax:330-543-3836
Practice Address - Street 1:1 PERKINS SQ
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44308-1063
Practice Address - Country:US
Practice Address - Phone:330-543-8730
Practice Address - Fax:330-543-3836
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.04680-NP363LF0000X
OHNP04680363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily