Provider Demographics
NPI:1891821005
Name:GAUTHIER, SHIRLIN (ANP)
Entity Type:Individual
Prefix:
First Name:SHIRLIN
Middle Name:
Last Name:GAUTHIER
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:SHIRLIN
Other - Middle Name:
Other - Last Name:GAUTHIER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC, ANP
Mailing Address - Street 1:5370 DONOHOE AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-7401
Mailing Address - Country:US
Mailing Address - Phone:541-207-4835
Mailing Address - Fax:
Practice Address - Street 1:2401 RIVER RD
Practice Address - Street 2:STE 101
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97404
Practice Address - Country:US
Practice Address - Phone:541-431-0631
Practice Address - Fax:541-687-8631
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-24
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0006445111NR0400X
FLARNP 618832363L00000X
OR200550016363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner