Brian Paul Cloutier

Primary specialty

Rehabilitation Clinical Nurse SpecialistTaxonomy code 364SR0400X

Practice address

5577 E Bavarian Pass
Fridley, MN 55432-6049

Phone

(763) 502-7638

Fax

(612) 460-2400

NPI assigned

Aug 31, 2007

Last updated

Aug 31, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188518400000",
    "number": "1700070786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5577 E BAVARIAN PASS",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554326049",
            "telephone_number": "763-502-7638",
            "fax_number": "612-460-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5577 E BAVARIAN PASS",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554326049",
            "telephone_number": "763-502-7638",
            "fax_number": "612-460-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOUTIER",
        "first_name": "BRIAN",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-31",
        "last_updated": "2007-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SR0400X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Rehabilitation",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Nurse Specialist in Fridley, MN
• Providers in Fridley, MN by specialty
• Clinical Nurse Specialist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.