Provider Demographics
NPI:1962801902
Name:WEGNER, KATARZYNA (FNP)
Entity type:Individual
Prefix:MS
First Name:KATARZYNA
Middle Name:
Last Name:WEGNER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KATARZYNA
Other - Middle Name:
Other - Last Name:CAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:250 W CONTINENTAL RD STE 500
Mailing Address - Street 2:
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85622-3592
Mailing Address - Country:US
Mailing Address - Phone:520-427-6051
Mailing Address - Fax:
Practice Address - Street 1:250 W CONTINENTAL RD STE 500
Practice Address - Street 2:
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85622-3592
Practice Address - Country:US
Practice Address - Phone:520-260-0670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-15
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP5660363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily