Provider Demographics
NPI:1538790498
Name:ROMAN, KATHERINE WEHNER (FNP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:WEHNER
Last Name:ROMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HYGEIA DR STE 1420
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2049
Mailing Address - Country:US
Mailing Address - Phone:302-623-3017
Mailing Address - Fax:302-266-9960
Practice Address - Street 1:200 HYGEIA DR STE 1420
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2049
Practice Address - Country:US
Practice Address - Phone:302-623-3017
Practice Address - Fax:302-266-9960
Is Sole Proprietor?:No
Enumeration Date:2020-01-30
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0044725163W00000X
DELG-0001351363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse