| Doctor Name: | COLLEEN CLARKE-ROMERO |
| NPI Number: | 1154615268 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | R169698 |
| Business Practice Address: | 37767 Market Dr Charlotte Hall, MD - 206223188 |
| Business Phone Number: | 3018840278 |
| Business Fax Number: | |
| Mailing Address: | 37767 Market Dr Unit 2, CHARLOTTE HALL |
| State: | MD |
| Postal Code: | 206223198 |
| Phone Number: | 3018847322 |
| Fax Number: | 3018848663 |
| NPI Enumeration Date: | 06/06/2011 |
| NPI Last Update Date: | 07/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R169698 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |