Provider Demographics
NPI:1225183197
Name:BOERGER, SHEILA A
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:A
Last Name:BOERGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7915 W 59TH TER
Mailing Address - Street 2:
Mailing Address - City:MERRIAM
Mailing Address - State:KS
Mailing Address - Zip Code:66202-3005
Mailing Address - Country:US
Mailing Address - Phone:913-484-3845
Mailing Address - Fax:
Practice Address - Street 1:7915 W 59TH TER
Practice Address - Street 2:
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66202-3005
Practice Address - Country:US
Practice Address - Phone:913-484-3845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO001188225XP0200X
KS17-00824225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics