Shane Renee Clark
Licensed Practical Nurse • Dayton, OH
Professional Overview & Biography Verified Profile Summary
Shane Clark is a registered healthcare professional specializing in Licensed Practical Nurse in Dayton, OH. Practice services are available at 5107 GOODYEAR DR under active NPI credentials.
Practice Location & Contact Primary Location
5107 Goodyear Dr
Dayton, OH 454061135
Specialty Benchmarks & Practice Insights
Comparative analytics for Licensed Practical Nurse in Dayton, OH
Practicing in Dayton, OH (13034 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
CMS Verified: 2026-03-21NUCC Taxonomy Code: 164W00000X
An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
NPI status registered as active in NPPES database
Registered at 5107 GOODYEAR DR, DAYTON, OH 454061135 (Tel: 9374226497)
Registered at 5107 GOODYEAR DR, DAYTON, OH 454061135 (Tel: 9374226497)
Recorded as SHANE CLARK
Licensed Practical Nurse (License #194609 in OH)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
5107 Goodyear Dr
Dayton, OH 454061135
Phone: 9374226497
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