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NPI Code Detail

MEDICARE: DANIELLE LITA CLOUTIER PA-C

MEDICARE: DANIELLE LITA CLOUTIER PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant102766NC
2363AS0400XSurgical Physician Assistant102766NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1155VAOTHERNCBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093717209
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE LITA CLOUTIER PA-C
Provider Business Mailing Address
First Line : 1 HOSPITAL ROAD
Second Line : CALLER BOX C-268
City : CHEROKEE
State : NC
Zip : 28719-9253
Country : US
Telephone Number : 828-497-9163
Fax Number : 828-497-1723
Provider Business Practice Location Address
First Line : 1 HOSPITAL ROAD
Second Line : CALLER BOX C-268
City : CHEROKEE
State : NC
Zip : 28719-9253
Country : US
Telephone Number : 828-497-9163
Fax Number : 828-497-1723
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2005
Last Update Date : 04/12/2017

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Practice Location Address:
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CHEROKEE, NC
28719-9253
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Practice Fax: 828-497-1723

Directions to “ DANIELLE LITA CLOUTIER PA-C” Practice Location

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