Provider Demographics
NPI:1356590657
Name:CLOUTIER, GAIL A (FNP)
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:A
Last Name:CLOUTIER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CHABOT ST
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:ME
Mailing Address - Zip Code:04092-4817
Mailing Address - Country:US
Mailing Address - Phone:207-857-9311
Mailing Address - Fax:207-857-9324
Practice Address - Street 1:27 PORTLAND RD
Practice Address - Street 2:
Practice Address - City:BUXTON
Practice Address - State:ME
Practice Address - Zip Code:04093-6530
Practice Address - Country:US
Practice Address - Phone:207-929-5155
Practice Address - Fax:207-929-6571
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER051728363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily