KATIE WETHERILL APN NPI 1114936994

NPI Information

  • NPI: 1114936994
  • Provider Name: KATIE WETHERILL, APN
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 550 BROAD ST STE 606
    NEWARK, NJ
    ZIP 07102
  • Phone: (201) 822-1161

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NPI Details

Katie Wetherill, APN is a psychiatric/mental health nurse practitioner in Newark, NJ. Katie Wetherill, APN NPI is 1114936994. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

550 BROAD ST STE 606
NEWARK, NJ
ZIP 07102-537
Phone: (201) 822-1161
Fax: (877) 485-8918

The NPI 1114936994 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/7/2006 and was last updated on 9/20/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental Health26NJ00103500NEW JERSEYYes
2163WP0807XRegistered NursePsychiatric/Mental Health, Child & Adolescent26NJ00103500NEW JERSEYNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10112771MEDICAIDNEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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