MEDICARE: KATRINA OBERIO FUENTES RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH0200X	Home Health Registered Nurse	197002	CT

General Provider Information

NPI Number	:	1134075039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATRINA OBERIO FUENTES RN

Provider Business Mailing Address
First Line	:	2600 PARK AVE UNIT 2Y
Second Line	:
City	:	BRIDGEPORT
State	:	CT
Zip	:	06604-1307
Country	:	US
Telephone Number	:	212-532-7620
Fax Number	:

Provider Business Practice Location Address
First Line	:	2600 PARK AVE UNIT 2Y
Second Line	:
City	:	BRIDGEPORT
State	:	CT
Zip	:	06604-1307
Country	:	US
Telephone Number	:	212-532-7620
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2026
Last Update Date	:	03/05/2026

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