Provider Demographics
NPI:1245726694
Name:GLOVER-CLOUTIER, DANIELLE RENE (BSN, DNP, NP-C)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:RENE
Last Name:GLOVER-CLOUTIER
Suffix:
Gender:F
Credentials:BSN, DNP, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1057 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-2509
Mailing Address - Country:US
Mailing Address - Phone:360-665-3000
Mailing Address - Fax:360-665-3096
Practice Address - Street 1:21610 PACIFIC HIGHWAY
Practice Address - Street 2:
Practice Address - City:OCEAN PARK
Practice Address - State:WA
Practice Address - Zip Code:98640
Practice Address - Country:US
Practice Address - Phone:360-665-3000
Practice Address - Fax:360-665-3096
Is Sole Proprietor?:No
Enumeration Date:2018-07-09
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60883490363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily