Provider Demographics
NPI:1124676697
Name:PELANT, KATE JEAN (APRN, CNP)
Entity type:Individual
Prefix:
First Name:KATE
Middle Name:JEAN
Last Name:PELANT
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 EAST THIRD STREET
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55805-1951
Mailing Address - Country:US
Mailing Address - Phone:218-786-3146
Mailing Address - Fax:
Practice Address - Street 1:211 S BOUNDARY AVE
Practice Address - Street 2:
Practice Address - City:PROCTOR
Practice Address - State:MN
Practice Address - Zip Code:55810-2306
Practice Address - Country:US
Practice Address - Phone:218-576-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-28
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6975363LF0000X
MNPENDING390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program