Provider Demographics
NPI:1740255017
Name:MICHAELS, DEBBIE S (NP)
Entity type:Individual
Prefix:
First Name:DEBBIE
Middle Name:S
Last Name:MICHAELS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 S. SANTA FE AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-4189
Mailing Address - Country:US
Mailing Address - Phone:785-452-6100
Mailing Address - Fax:785-452-6016
Practice Address - Street 1:400 S. SANTA FE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-4144
Practice Address - Country:US
Practice Address - Phone:785-452-6100
Practice Address - Fax:785-452-6016
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-78726363L00000X
IAH096774363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA500029149OtherRAILROAD MEDICARE
KS201245460AMedicaid
IA1740255017Medicaid
IA0634550Medicaid
IA163455Medicare PIN
IAS33790Medicare UPIN
IA0634550Medicaid
IA1740255017Medicaid
IA163455Medicare PIN