Healthcare Provider Details

I. General information

NPI: 1285575514
Provider Name (Legal Business Name): PATRICIA GILK
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 WATER ST
EXCELSIOR MN
55331-3040
US

IV. Provider business mailing address

370 WATER ST
EXCELSIOR MN
55331-3040
US

V. Phone/Fax

Practice location:
  • Phone: 953-913-6973
  • Fax:
Mailing address:
  • Phone: 953-913-6973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2466834
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: