Provider Demographics
NPI:1982600045
Name:MERHAUT, SHAWN M (CNP)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:M
Last Name:MERHAUT
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 EUCLID AVE
Mailing Address - Street 2:J3-4
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-444-8448
Mailing Address - Fax:216-444-8448
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:J3-4
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-444-8448
Practice Address - Fax:216-444-8448
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH284698363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2315266Medicaid
OHP58221Medicare UPIN
OH2315266Medicaid