Provider Demographics
NPI:1780082040
Name:VANBUSKIRK, SHEILA
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:VANBUSKIRK
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 1:10425 CHESTNUT DR
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64137-3201
Mailing Address - Country:US
Mailing Address - Phone:816-763-4444
Mailing Address - Fax:816-761-7462
Practice Address - Street 1:10425 CHESTNUT DR
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64137-3201
Practice Address - Country:US
Practice Address - Phone:816-763-4444
Practice Address - Fax:816-761-7462
Is Sole Proprietor?:No
Enumeration Date:2014-12-18
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010035023224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant