Provider Demographics
NPI:1891725107
Name:DEPRIEST, ELIZABETH A (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:A
Last Name:DEPRIEST
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MRS
Other - First Name:ELIZABETH
Other - Middle Name:A
Other - Last Name:DEPRIEST REUTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:10720 NALL AVE
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1206
Mailing Address - Country:US
Mailing Address - Phone:913-754-5000
Mailing Address - Fax:913-754-4560
Practice Address - Street 1:10720 NALL AVE
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1206
Practice Address - Country:US
Practice Address - Phone:913-754-5000
Practice Address - Fax:913-754-4560
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1456771112163W00000X
KS55124367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200355380CMedicaid
KSP00619216OtherRR MEDICARE
KSP800634Medicare PIN