Healthcare Provider Details

I. General information

NPI: 1770243768
Provider Name (Legal Business Name): CHARLA ROMERO DNP FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHARLA LYCAN DNP FNP-C

II. Dates (important events)

Enumeration Date: 12/18/2021
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER DR
MORGANTOWN WV
26506-1200
US

IV. Provider business mailing address

PO BOX 780
MORGANTOWN WV
26507-0780
US

V. Phone/Fax

Practice location:
  • Phone: 304-598-4000
  • Fax:
Mailing address:
  • Phone: 304-285-7101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0997201-NP
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0997201-NP
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number122881
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: