Provider Demographics
NPI:1073813036
Name:MEYER, DEBORAH ANN (APRN)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:MEYER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 219209
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64121-9209
Mailing Address - Country:US
Mailing Address - Phone:913-226-7332
Mailing Address - Fax:913-764-5563
Practice Address - Street 1:11111 NALL AVE STE 103
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1625
Practice Address - Country:US
Practice Address - Phone:913-424-3019
Practice Address - Fax:913-490-1080
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS68205363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1073813037Medicaid
MOMA3153004Medicare PIN
KSKA2105002Medicare PIN