Provider Demographics
NPI:1730587247
Name:KARBEL, KATHERINE WELLS (RD)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:WELLS
Last Name:KARBEL
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 PINE LEDGE DR
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-8832
Mailing Address - Country:US
Mailing Address - Phone:970-222-8009
Mailing Address - Fax:
Practice Address - Street 1:805 STEVENS AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-2647
Practice Address - Country:US
Practice Address - Phone:207-772-6279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-15
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDI1222133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered