Medizen Revitalize

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

MEDIZEN REVITALIZE

Practice address

11407 W Sondra St
Maize, KS 67101-9014

Phone

(316) 285-0505

Fax

(763) 314-4990

NPI assigned

Mar 13, 2026

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Delicia BawlNPI 1013344589

Title

Owner

Phone

(316) 807-3069

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Delicia C. Bawl, APRN

  • Family Nurse Practitioner
  • Maize, KS
  • NPI 1013344589

  Psychiatric/Mental Health

  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1773360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773360000000",
    "number": "1427905967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11407 W SONDRA ST",
            "city": "MAIZE",
            "state": "KS",
            "postal_code": "671019014",
            "telephone_number": "316-285-0505",
            "fax_number": "763-314-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11407 W SONDRA ST",
            "city": "MAIZE",
            "state": "KS",
            "postal_code": "671019014",
            "telephone_number": "316-285-0505",
            "fax_number": "763-314-4990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIZEN REVITALIZE",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-13",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A",
        "authorized_official_last_name": "BAWL",
        "authorized_official_first_name": "DELICIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "316-807-3069"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maize Dialysis Center LLC
• Maize Usd 266
• Matthew R. Healy D.D.S., P.a.
• Britta K Maxwell, PNP-AC
• Medhealth Check LLC
• Meryl Elizabeth Miller, D.C.
• Janelle Myers
• Thu Nguyen, PHARMD
• Elena A O'Donnell, PTA
• Juwan A Offray

• All providers in Maize, KS
• Psychiatric/Mental Health Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.