Provider Demographics
NPI:1972768786
Name:KRAMER, SHAYLA LEANN (PT)
Entity type:Individual
Prefix:
First Name:SHAYLA
Middle Name:LEANN
Last Name:KRAMER
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 1:740 HIGHLAND TER
Mailing Address - Street 2:
Mailing Address - City:LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66048-5185
Mailing Address - Country:US
Mailing Address - Phone:816-405-9396
Mailing Address - Fax:
Practice Address - Street 1:757 W EISENHOWER
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:KS
Practice Address - Zip Code:66043
Practice Address - Country:US
Practice Address - Phone:913-565-9030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1103821225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2008024680OtherSTATE OF MISSOURI DIVISION OF PROFESSIONAL REGISTRATION
KS11-03821OtherKANSAS STATE BOARD OF HEALING ARTS