Provider Demographics
NPI:1750797643
Name:GEGARIS, CATHERINE M (AGPCNP-BC)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:M
Last Name:GEGARIS
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 N REHOBOTH BLVD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19963-1303
Mailing Address - Country:US
Mailing Address - Phone:302-339-5761
Mailing Address - Fax:302-424-2661
Practice Address - Street 1:255 N REHOBOTH BLVD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-1303
Practice Address - Country:US
Practice Address - Phone:302-339-5761
Practice Address - Fax:302-424-2661
Is Sole Proprietor?:No
Enumeration Date:2014-07-11
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
DELP 0000114363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program