Healthcare Provider Details

I. General information

NPI: 1023119765
Provider Name (Legal Business Name): DEBRA L REZAC ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. DEBRA ALLEN

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 WEST 8TH STREET
ONAGA KS
66521-9547
US

IV. Provider business mailing address

114 WEST 8TH STREET
ONAGA KS
66521-9547
US

V. Phone/Fax

Practice location:
  • Phone: 785-889-4241
  • Fax: 785-889-4749
Mailing address:
  • Phone: 785-889-4241
  • Fax: 785-889-4749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-45912
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number53-45912
License Number StateKS
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number53-45912
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: