Provider Demographics
NPI:1528011145
Name:ZAER RAFIE, REBECCA (FNP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:ZAER RAFIE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:ZAER
Other - Last Name:RAFIE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN-FNP
Mailing Address - Street 1:819 W 122ND TER
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64145-1123
Mailing Address - Country:US
Mailing Address - Phone:210-473-5350
Mailing Address - Fax:
Practice Address - Street 1:12330 METCALF AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-1324
Practice Address - Country:US
Practice Address - Phone:210-473-5350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRN519838363LF0000X
KS76753363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F1939Medicare ID - Type Unspecified
TXQ54979Medicare UPIN