Healthcare Provider Details

I. General information

NPI: 1548664436
Provider Name (Legal Business Name): MACKENZIE STEGMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MACKENZIE BOONE

II. Dates (important events)

Enumeration Date: 10/21/2014
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 W 107TH ST
KANSAS CITY MO
64114-5919
US

IV. Provider business mailing address

516 PARMA WAY
GARDNER KS
66030-1474
US

V. Phone/Fax

Practice location:
  • Phone: 620-923-5165
  • Fax:
Mailing address:
  • Phone: 620-923-5165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: