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NPI Code Detail

MEDICARE: SHANE KLABER PMHNP

MEDICARE: SHANE KLABER PMHNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner0038761OH

General Provider Information

NPI Number : 1578369237
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANE KLABER PMHNP
Provider Business Mailing Address
First Line : 3481 S DIXIE HWY STE 267
Second Line :
City : MIDDLETOWN
State : OH
Zip : 45005-5717
Country : US
Telephone Number : 513-516-9293
Fax Number : 513-995-2281
Provider Business Practice Location Address
First Line : 6730 ROOSEVELT AVE STE 301
Second Line :
City : MIDDLETOWN
State : OH
Zip : 45005-5736
Country : US
Telephone Number : 513-928-3339
Fax Number : 513-928-3382
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2025
Last Update Date : 06/30/2025

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