Provider Demographics
NPI:1245243633
Name:STERNEKER, SHAWNA L (PT)
Entity Type:Individual
Prefix:
First Name:SHAWNA
Middle Name:L
Last Name:STERNEKER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4404 SW 170 AVE
Mailing Address - Street 2:
Mailing Address - City:CUNNINGHAM
Mailing Address - State:KS
Mailing Address - Zip Code:67035-8744
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:412 SANDY LN
Practice Address - Street 2:SOUTH CENTRAL KANSAS SPECIAL EDUCATION
Practice Address - City:PRATT
Practice Address - State:KS
Practice Address - Zip Code:67124-8458
Practice Address - Country:US
Practice Address - Phone:620-388-2890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-033052251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics