IndividualActive
Shannon Mauk
NPI 1083583579 · Registered Nurse · Willoughby, OH
Provider details
- NPI number
- 1083583579
- Entity type
- Individual
- Primary specialty
- Registered NurseNursing Service Providers
- Sex
- Female
- Sole proprietor
- No
- License
- RN.488689 (OH)
Specialties & taxonomies
Nursing Service Providers
Practice location
38876 Mentor Ave
Willoughby, OH 44094-7931
Phone: (440) 578-8200
Approximate (ZIP-level) locationGet directions
Mailing address
38876 Mentor Ave
Willoughby, OH 44094-7931
Registry dates
- Enumerated
- 2025-11-03
- Last updated
- 2025-11-03
- Certified
- 2025-11-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.