Provider Demographics
NPI:1518074004
Name:STENNES, DEBRA K (CRNA)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:K
Last Name:STENNES
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:DEBBIE
Other - Middle Name:K
Other - Last Name:STENNES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 411851
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64141-1851
Mailing Address - Country:US
Mailing Address - Phone:913-588-3736
Mailing Address - Fax:
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-8500
Practice Address - Country:US
Practice Address - Phone:913-588-3736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2017-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO149213367500000X
KS1341479061367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO27392029OtherBCBS OF KANSAS CITY
MO919792614Medicaid
MO919792614Medicaid
MO430067809Medicare ID - Type UnspecifiedRAILROAD MEDICARE