Individual provider · Type 1 NPI

Shane Brenna Devine, DO

Student in an Organized Health Care Education/Training Program · Wpafb, OH

NPI number 1245033471 Active

Practice location

88th Medical Group, 4881 Sugar Maple Dr.
Wpafb, OH 45433

Call (937) 257-9926 Map

Mailing address

4881 Sugar Maple Dr
Wpafb, OH 45433-5529

Specialties and licenses

TaxonomyCodeLicense
Military Health Care Provider 171000000XNone listed
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: 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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About NPI 1245033471

Shane Brenna Devine, DO's National Provider Identifier is 1245033471, issued on Mar 31, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Wpafb, OH. The record was last updated on Feb 23, 2026.