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Shane Clark
Student in an Organized Health Care Education/Training Program in Lansing, Michigan
NPI 1902391477

Shane Clark is a Student in an Organized Health Care Education/Training Program based in Lansing, MI. Shane Clark practices in Lansing, MI. The NPI Number for Shane Clark is 1902391477 and holds a License No. 5101024145 (Michigan).

The current practice location address for Shane Clark is 401 W Greenlawn Ave, Lansing, MI and can be reached out via phone at 517-975-6000.

Location: 401 W Greenlawn Ave, Lansing, MI, 48910-2819
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1902391477
Provider Name
Shane Clark
Credential
Provider Entity Type
Individual
Gender
Male
Address
401 W Greenlawn Ave, Lansing, MI, 48910-2819
Phone Number
517-975-6000
Fax Number
Provider Enumeration Date
06/27/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
401 W Greenlawn Ave
City
Lansing
State
Michigan
Zip
48910-2819
Phone Number
517-975-6000
Fax Number
person
Provider Business Mailing Address Details
Address
401 W Greenlawn Ave
City
Lansing
State
Michigan
Zip
48910-2819
Phone Number
517-975-6000
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
5101024145 (Michigan)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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