Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shane Renee Clark

Individual provider Licensed Practical Nurse · NPI 1023956257

Shane Renee Clark is a Licensed Practical Nurse in Dayton, Ohio. Practices as a sole proprietor. Licensed in Ohio.

Licensed in
OH
In the registry since
2026

Practice location Address checks out

5107 Goodyear Dr
Dayton, OH 45406-1135
Phone: (937) 422-6497
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Licensed Practical Nurse (primary) Taxonomy 164W00000X · Licence 194609 (OH)

Record details

NPI number1023956257
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 21, 2026
Last updated in NPPESMarch 21, 2026
Certification dateMarch 21, 2026
Mailing address5107 Goodyear Dr, Dayton, OH 45406-1135

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