Provider Demographics
NPI:1740633858
Name:MEASEL, KATIE (RDH)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:MEASEL
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AVENUE D' OSLO BLD. 401
Mailing Address - Street 2:
Mailing Address - City:SHAPE
Mailing Address - State:HANUIT
Mailing Address - Zip Code:7010
Mailing Address - Country:BE
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:AVENUE D' OSLO BLD. 401
Practice Address - Street 2:
Practice Address - City:HAPE
Practice Address - State:HANUIT
Practice Address - Zip Code:7010
Practice Address - Country:BE
Practice Address - Phone:3206-532-5328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-14
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC08562124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist