Provider Demographics
NPI:1871794024
Name:GEISTKEMPER-RAGLAND, SHERYL (PT)
Entity type:Individual
Prefix:
First Name:SHERYL
Middle Name:
Last Name:GEISTKEMPER-RAGLAND
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 1:9700 W 96TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-5105
Mailing Address - Country:US
Mailing Address - Phone:913-993-2672
Mailing Address - Fax:
Practice Address - Street 1:9700 W 96TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-5105
Practice Address - Country:US
Practice Address - Phone:913-993-2672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-02506174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist