Provider Demographics
NPI:1164142006
Name:TABELMAN, SHAWN N (RN)
Entity Type:Individual
Prefix:MS
First Name:SHAWN
Middle Name:N
Last Name:TABELMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3144 W KEEPSAKE LN
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:IN
Mailing Address - Zip Code:46157-6140
Mailing Address - Country:US
Mailing Address - Phone:317-220-5193
Mailing Address - Fax:
Practice Address - Street 1:3144 W KEEPSAKE LN
Practice Address - Street 2:
Practice Address - City:MONROVIA
Practice Address - State:IN
Practice Address - Zip Code:46157-6140
Practice Address - Country:US
Practice Address - Phone:317-220-5193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28257945C163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice