| Doctor Name: | NICOLE RENEE CLOUTIER |
| NPI Number: | 1114241668 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 1102 W 32nd St Joplin, MO - 648043503 |
| Business Phone Number: | 4173474616 |
| Business Fax Number: | 4173470288 |
| Mailing Address: | 1336 Ne Parvin Rd, Apt #202 KANSAS CITY |
| State: | MO |
| Postal Code: | 641165002 |
| Phone Number: | 3034891096 |
| Fax Number: | |
| NPI Enumeration Date: | 03/25/2010 |
| NPI Last Update Date: | 10/02/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MO |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |