Provider Demographics
NPI:1679374268
Name:SHEIN, KATHERINE BLAIR
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:BLAIR
Last Name:SHEIN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3023 CASS ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-2015
Mailing Address - Country:US
Mailing Address - Phone:847-804-7411
Mailing Address - Fax:
Practice Address - Street 1:16923 JOANNE DR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68136-4146
Practice Address - Country:US
Practice Address - Phone:847-804-7411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program