Provider Demographics
NPI:1396378188
Name:RZIHA, MICHAELA ELIZABETH (PA)
Entity type:Individual
Prefix:MRS
First Name:MICHAELA
Middle Name:ELIZABETH
Last Name:RZIHA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MISS
Other - First Name:MICHAELA
Other - Middle Name:ELIZABETH
Other - Last Name:BRETEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 RAVENHILL DR
Mailing Address - Street 2:
Mailing Address - City:ATCHISON
Mailing Address - State:KS
Mailing Address - Zip Code:66002-9204
Mailing Address - Country:US
Mailing Address - Phone:913-367-2131
Mailing Address - Fax:
Practice Address - Street 1:800 RAVENHILL DR STE 100&107
Practice Address - Street 2:
Practice Address - City:ATCHISON
Practice Address - State:KS
Practice Address - Zip Code:66002-9204
Practice Address - Country:US
Practice Address - Phone:913-367-7300
Practice Address - Fax:913-674-2030
Is Sole Proprietor?:No
Enumeration Date:2020-02-19
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10003387A363A00000X
KS15-02778363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300056562Medicaid