Provider Demographics
NPI:1497599583
Name:CLUTTERBUCK, HELENE WARREN (PA-C)
Entity type:Individual
Prefix:
First Name:HELENE
Middle Name:WARREN
Last Name:CLUTTERBUCK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:HELENE
Other - Middle Name:WARREN
Other - Last Name:KERINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:360 US HIGHWAY 1 BYP UNIT 102
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-7105
Mailing Address - Country:US
Mailing Address - Phone:603-410-6700
Mailing Address - Fax:
Practice Address - Street 1:8 LOUDON RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5300
Practice Address - Country:US
Practice Address - Phone:603-226-9000
Practice Address - Fax:603-226-2268
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-24
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2160363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant