Healthcare Provider Details

I. General information

NPI: 1780097139
Provider Name (Legal Business Name): KATALIN VANEGAS APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATALIN VANEGAS DNP,ARNP

II. Dates (important events)

Enumeration Date: 06/03/2014
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1535 SAVANNAH RD
LEWES DE
19958-1611
US

IV. Provider business mailing address

122 E COLLEGE AVE
APPLETON WI
54911-5741
US

V. Phone/Fax

Practice location:
  • Phone: 302-645-3232
  • Fax: 302-645-3833
Mailing address:
  • Phone: 920-996-3264
  • Fax: 920-830-5910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberLP-0010746
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberARNP9276976
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: