Provider Demographics
NPI:1861537508
Name:SURMEIER, SHEILA ANN (OTR)
Entity type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:ANN
Last Name:SURMEIER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MS
Other - First Name:SHEILA
Other - Middle Name:ANN
Other - Last Name:DESBIEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA
Mailing Address - Street 1:4014 W HAVERILL DR
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-1339
Mailing Address - Country:US
Mailing Address - Phone:816-351-2019
Mailing Address - Fax:
Practice Address - Street 1:1343 VILLAGE DRIVE
Practice Address - Street 2:
Practice Address - City:ST JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506
Practice Address - Country:US
Practice Address - Phone:816-232-2878
Practice Address - Fax:816-232-5056
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1700638225X00000X
MO001248225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO20623017OtherBCBS