Shane C. Allman, LPN

Individual provider Active NPI Licensed Practical Nurse · Pataskala, OH

NPI 1306018486 · NPPES record last updated Mar 28, 2008

Key facts

NPI
1306018486
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
PN. 115801 IV (OH)
Practice address
180 Shaleridge Dr
Pataskala, OH 43062-8171
Phone
(740) 964-9796
NPI assigned
Mar 28, 2008
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PN. 115801 IVOHMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN. 115801 IV OH Yes

Addresses

Primary practice location

180 Shaleridge Dr
Pataskala, OH 43062-8171

Mailing address

180 Shaleridge Dr.
Pataskala, OH 43062
Phone (740) 964-9796

Other identifiers

IdentifierTypeStateIssuer
2492306MedicaidOH

Other providers in Pataskala, OH

All providers in Pataskala, OH · Licensed Practical Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.