Provider Demographics
NPI:1508933565
Name:GLEASON ALT, SHEENA MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:SHEENA
Middle Name:MARIE
Last Name:GLEASON ALT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SHEENA
Other - Middle Name:MARIE
Other - Last Name:GLEASON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2316 E MEYER BLVD
Mailing Address - Street 2:ROOM 347
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64132-1136
Mailing Address - Country:US
Mailing Address - Phone:816-276-4360
Mailing Address - Fax:816-276-3970
Practice Address - Street 1:2316 E MEYER BLVD
Practice Address - Street 2:ROOM 347
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64132-1136
Practice Address - Country:US
Practice Address - Phone:816-276-4360
Practice Address - Fax:816-276-3970
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-33634207R00000X, 208000000X
MO2009004970208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics