Healthcare Provider Details

I. General information

NPI: 1598618399
Provider Name (Legal Business Name): JULIA ROTTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2026
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 STOCKINGER DR
SAINT CLOUD MN
56303-1243
US

IV. Provider business mailing address

2169 LACHMAN AVE NE
SAINT MICHAEL MN
55376-4208
US

V. Phone/Fax

Practice location:
  • Phone: 320-240-2832
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number13952
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: