Individual
MRS. JOAN MARIE KOTILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN CNP
Contact information
Practice address
251 COUNTY ROAD 120, SAINT CLOUD, MN 56303-4872
(320) 202-8949
(320) 257-1733
Mailing address
CENTRACARE CLINIC ST CLOUD MEDICAL GROUP NORTHWEST, 251 COUNTY ROAD 120, ST CLOUD, MN 56303-4872
(320) 202-8949
(320) 257-1733
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2019769
MN
363LF0000X
Family Nurse Practitioner
Primary
5273
MN
Other
Enumeration date
11/14/2017
Last updated
11/14/2017
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