Provider Demographics
NPI:1679751267
Name:DE ROMANA, KATRINA M (MSN, FNP)
Entity Type:Individual
Prefix:MRS
First Name:KATRINA
Middle Name:M
Last Name:DE ROMANA
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 S PERRY ST STE 104B
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-1950
Mailing Address - Country:US
Mailing Address - Phone:720-272-7771
Mailing Address - Fax:
Practice Address - Street 1:1001 S PERRY ST STE 105B
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-1921
Practice Address - Country:US
Practice Address - Phone:720-485-3178
Practice Address - Fax:720-414-0006
Is Sole Proprietor?:No
Enumeration Date:2008-02-05
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5556363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO10652370Medicaid