Provider Demographics
NPI:1023119765
Name:REZAC, DEBRA L (ARNP)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:L
Last Name:REZAC
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:DEBRA
Other - Middle Name:
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:114 WEST 8TH STREET
Mailing Address - Street 2:
Mailing Address - City:ONAGA
Mailing Address - State:KS
Mailing Address - Zip Code:66521-9547
Mailing Address - Country:US
Mailing Address - Phone:785-889-4241
Mailing Address - Fax:785-889-4749
Practice Address - Street 1:114 WEST 8TH STREET
Practice Address - Street 2:
Practice Address - City:ONAGA
Practice Address - State:KS
Practice Address - Zip Code:66521-9547
Practice Address - Country:US
Practice Address - Phone:785-889-4241
Practice Address - Fax:785-889-4749
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-45912363LF0000X, 363LP2300X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200404000AMedicaid