Provider Demographics
NPI:1194075002
Name:HAMEL, KATRINA CELESTE (PA-C)
Entity type:Individual
Prefix:MS
First Name:KATRINA
Middle Name:CELESTE
Last Name:HAMEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:KATRINA
Other - Middle Name:CELESTE
Other - Last Name:REBOLLOSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9045 US HIGHWAY 31
Mailing Address - Street 2:SUITE A
Mailing Address - City:BERRIEN SPRINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49103-1804
Mailing Address - Country:US
Mailing Address - Phone:269-473-2222
Mailing Address - Fax:269-473-6880
Practice Address - Street 1:9045 US HIGHWAY 31
Practice Address - Street 2:SUITE A
Practice Address - City:BERRIEN SPRINGS
Practice Address - State:MI
Practice Address - Zip Code:49103-1804
Practice Address - Country:US
Practice Address - Phone:269-473-2222
Practice Address - Fax:269-473-6880
Is Sole Proprietor?:No
Enumeration Date:2012-09-18
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant