Provider Demographics
NPI:1215355995
Name:CLOUTHIER, KATIE (DO)
Entity Type:Individual
Prefix:DR
First Name:KATIE
Middle Name:
Last Name:CLOUTHIER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 GATTIS APT 304
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-7390
Mailing Address - Country:US
Mailing Address - Phone:603-491-5901
Mailing Address - Fax:
Practice Address - Street 1:333 S COLUMBIA ST 417 MACNIDER HALL CB 7221
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-3322
Practice Address - Country:US
Practice Address - Phone:919-966-7495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2017-00762208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics