Provider Demographics
NPI:1336345867
Name:DEBAUGE-KATZER, ELIZABETH PATRICE (CRNA)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:PATRICE
Last Name:DEBAUGE-KATZER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:PATRICE
Other - Last Name:DEBAUGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:7617 W 64TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66202-3812
Mailing Address - Country:US
Mailing Address - Phone:816-210-7512
Mailing Address - Fax:
Practice Address - Street 1:7617 W 64TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66202-3812
Practice Address - Country:US
Practice Address - Phone:816-210-7512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS55597367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS013F312Medicare PIN