Provider Demographics
NPI:1205492196
Name:CLOUTIER, JOHN-PAUL (NP)
Entity type:Individual
Prefix:
First Name:JOHN-PAUL
Middle Name:
Last Name:CLOUTIER
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:181 CRAWFORD ROAD
Mailing Address - Street 2:PO BOX 724
Mailing Address - City:NEWPORT
Mailing Address - State:VT
Mailing Address - Zip Code:05855-0724
Mailing Address - Country:US
Mailing Address - Phone:802-334-6744
Mailing Address - Fax:802-473-4120
Practice Address - Street 1:181 CRAWFORD ROAD
Practice Address - Street 2:PO BOX 724
Practice Address - City:NEWPORT
Practice Address - State:VT
Practice Address - Zip Code:05855-0724
Practice Address - Country:US
Practice Address - Phone:802-334-6744
Practice Address - Fax:802-473-4120
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-15
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101.0134317363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health