Provider Demographics
NPI:1750867248
Name:SHKIRYAK, MIKHAIL P (ARNP)
Entity Type:Individual
Prefix:
First Name:MIKHAIL
Middle Name:P
Last Name:SHKIRYAK
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 E WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:50138-1948
Mailing Address - Country:US
Mailing Address - Phone:641-204-9752
Mailing Address - Fax:
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-356-2572
Practice Address - Fax:319-356-4505
Is Sole Proprietor?:No
Enumeration Date:2018-07-17
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA130813363L00000X
IAF07181382363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA130813OtherIOWA BOARD OF NURSING