Provider Demographics
NPI:1568416550
Name:MORGAN, DEBRA J BUCKLE (FNP, PMHNP)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:J BUCKLE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:FNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2243 N HORSESHOE CIR
Mailing Address - Street 2:
Mailing Address - City:DERBY
Mailing Address - State:KS
Mailing Address - Zip Code:67037-8657
Mailing Address - Country:US
Mailing Address - Phone:816-225-5387
Mailing Address - Fax:
Practice Address - Street 1:4013 N RIDGE RD STE 110
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-8859
Practice Address - Country:US
Practice Address - Phone:316-201-6294
Practice Address - Fax:316-364-3020
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO122215363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1568416550Medicaid
MO1447412770OtherRH MEDICAID - NURSE PRACTITIONER
MO428750509Medicaid
MO597780303OtherRH MEDICAID-NURSE PRACTIT
MO268630Medicare Oscar/Certification
MO268535Medicare Oscar/Certification
MO821292169Medicare PIN
MO1568416550Medicaid