Active NPI
Kaitlyn Latour
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Saint Cloud, MN
National Provider Identifier
1215470943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 121829
- Practice address
- 4801 Veterans Dr
Saint Cloud, MN 56303-2015 - Phone
- (320) 252-1670
- NPI assigned
- Nov 29, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 121829 | MN | Primary |
Addresses
Primary practice location
4801 Veterans Dr
Saint Cloud, MN 56303-2015
Mailing address
3500 County Road 39 NW
Maple Lake, MN 55358-3019
Phone (320) 333-2804
Other practice location 1
3500 County Road 39 NW
Maple Lake, MN 55358-3019
Phone (320) 333-2804
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 121829 | MN | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1480377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739232000000",
"number": "1215470943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3500 COUNTY ROAD 39 NW",
"city": "MAPLE LAKE",
"state": "MN",
"postal_code": "553583019",
"telephone_number": "320-333-2804",
"fax_number": "320-243-7910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4801 VETERANS DR",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563032015",
"telephone_number": "320-252-1670"
}
],
"practiceLocations": [
{
"address_1": "3500 County Road 39 NW",
"address_purpose": "LOCATION",
"city": "Maple Lake",
"state": "MN",
"postal_code": "553583019",
"country_code": "US",
"telephone_number": "320-333-2804",
"fax_number": "320-243-7910",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LATOUR",
"first_name": "KAITLYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-29",
"last_updated": "2025-02-11",
"certification_date": "2025-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "MN",
"license": "121829",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Cloud, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.