Provider Demographics
NPI:1558657023
Name:DAO, DEBBIE (APRN)
Entity Type:Individual
Prefix:MS
First Name:DEBBIE
Middle Name:
Last Name:DAO
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 1:2622 W CENTRAL AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-4970
Mailing Address - Country:US
Mailing Address - Phone:316-858-1111
Mailing Address - Fax:316-946-5105
Practice Address - Street 1:2622 W CENTRAL AVE STE 101
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-4970
Practice Address - Country:US
Practice Address - Phone:316-858-1111
Practice Address - Fax:316-946-5105
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-75354363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
003768058Medicare PIN
OK200481830AOtherMEDICAID
KS200738520BMedicaid
KS200738520AMedicaid