Provider Demographics
NPI:1073408878
Name:WENTLING, KATHERINE COLLEEN
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:COLLEEN
Last Name:WENTLING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4911 ANDREWS HWY STE B
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79703-4507
Mailing Address - Country:US
Mailing Address - Phone:432-888-7455
Mailing Address - Fax:
Practice Address - Street 1:4911 ANDREWS HWY STE B
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79703-4507
Practice Address - Country:US
Practice Address - Phone:432-888-7455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1172152363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology