Healthcare Provider Details

I. General information

NPI: 1013540921
Provider Name (Legal Business Name): DIANA MARIA CLOUTHIER MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2020
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3425 AUSTIN BLUFFS PKWY STE 100
COLORADO SPRINGS CO
80918-5701
US

IV. Provider business mailing address

3425 AUSTIN BLUFFS PKWY STE 100
COLORADO SPRINGS CO
80918-5701
US

V. Phone/Fax

Practice location:
  • Phone: 719-257-4000
  • Fax: 877-807-6813
Mailing address:
  • Phone: 719-257-4000
  • Fax: 877-807-6813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0038223
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: