Individual
KATRINA N MASTERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
124 SAGAMORE PKWY W, WEST LAFAYETTE, IN 47906-1569
(765) 463-6722
(765) 463-0905
Mailing address
124 SAGAMORE PKWY W, WEST LAFAYETTE, IN 47906-1569
(765) 463-6722
(765) 463-0905
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71001365A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28099675A
REGISTERED NURSE LICENSE
IN
01
—
71001365A
NURSE PRACTITIONER LICENS
IN
01
—
71001365B
CONTROLLED SUBSTANCE REGI
IN
Enumeration date
06/27/2006
Last updated
12/19/2024
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