Healthcare Provider Details

I. General information

NPI: 1235129644
Provider Name (Legal Business Name): KATHERINE E PILLOTE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 CENTRACARE CIRCLE
ST CLOUD MN
56303
US

IV. Provider business mailing address

1900 CENTRACARE CIRCLE
ST CLOUD MN
56303
US

V. Phone/Fax

Practice location:
  • Phone: 320-229-5000
  • Fax: 320-229-5184
Mailing address:
  • Phone: 320-229-5000
  • Fax: 320-229-5184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number45467
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: