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General NPI Number Information
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NPI Number | 1578369237
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Entity Type | Individual
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Provider Name | SHANE KLABER PMHNP
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Gender | Male
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Dates
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Enumeration Date | 02/24/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 6730 ROOSEVELT AVE STE 301
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City | MIDDLETOWN
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State | OH
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Zip | 45005-5736
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Country | US
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Telephone | 513-928-3339
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Fax | 513-928-3382
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Provider Business Mailing Address
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Address Line | 3481 S DIXIE HWY STE 267
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City | MIDDLETOWN
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State | OH
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Zip | 45005-5717
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Country | US
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Telephone | 513-516-9293
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Fax | 513-995-2281
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0038761
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License Number State | OH
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