Provider Demographics
NPI:1851070858
Name:SHEBLE, JESSICA D (OTR)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:D
Last Name:SHEBLE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8580 CARDINAL ST APT 6104
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66219-8088
Mailing Address - Country:US
Mailing Address - Phone:913-327-9643
Mailing Address - Fax:
Practice Address - Street 1:1061 E 151ST ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-3417
Practice Address - Country:US
Practice Address - Phone:913-829-3133
Practice Address - Fax:913-829-6011
Is Sole Proprietor?:No
Enumeration Date:2023-07-17
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225XH1200X
MO2023034311225XH1200X
KS17-04244225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand