Healthcare Provider Details

I. General information

NPI: 1346969334
Provider Name (Legal Business Name): KATHERINE E PELOTTE APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE E HARRIS

II. Dates (important events)

Enumeration Date: 08/24/2022
Last Update Date: 02/26/2024
Certification Date: 02/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

149 NORTH ST
WATERVILLE ME
04901-4974
US

IV. Provider business mailing address

199 CIANCHETTE ST
PITTSFIELD ME
04967-4554
US

V. Phone/Fax

Practice location:
  • Phone: 207-872-1800
  • Fax:
Mailing address:
  • Phone: 207-858-2352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number390200000X
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberCNP221605
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: