Most Relevant Information
Provider Data
| NPI Number: | 1003425281 |
| Provider Name: | JESSICA SHATTUCK APRN-CNM, WHNP-BC |
| Entity Type: | Individual |
| Taxonomy Code: | 363LW0102X |
| Specialty: | Nurse Practitioner |
| License Number: | 0027135 |
Most Important Dates
| Enumeration Date: | 07/23/2020 |
| Last Updated: | 02/02/2021 |
Provider Practice Location
108 SLIPPERY ROCK LN
BEREA
OH
440173155
Practice Location Phone/Fax
| Phone: | 4406103710 |
| Fax: |
Provider Mailing Location
108 SLIPPERY ROCK LN
BEREA
OH
440173155
Provider Mailing Phone/Fax
| Phone: | 4406103710 |
| Fax: |