Provider Demographics
NPI:1477682391
Name:GILBERT, SHARI LYNN (PTA)
Entity Type:Individual
Prefix:
First Name:SHARI
Middle Name:LYNN
Last Name:GILBERT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 NE HIDDEN VALLEY LN
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64064-2351
Mailing Address - Country:US
Mailing Address - Phone:816-478-4717
Mailing Address - Fax:
Practice Address - Street 1:2 E GREGORY BLVD STE 200
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-1118
Practice Address - Country:US
Practice Address - Phone:816-926-0208
Practice Address - Fax:816-926-0277
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005032246225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2005032246OtherSTATE LICENSE