Provider Demographics
NPI:1558610378
Name:HATTEL, KATIE LYNN (RPH)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:LYNN
Last Name:HATTEL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 MEADOW HILLS DR
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3320
Mailing Address - Country:US
Mailing Address - Phone:406-270-7431
Mailing Address - Fax:
Practice Address - Street 1:202 2ND AVE W
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-4488
Practice Address - Country:US
Practice Address - Phone:406-257-4806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-07
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT12408183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist