Provider Demographics
NPI:1003245135
Name:GUTIERREZ, DEBBIE (LPN)
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 WARNER RD
Mailing Address - Street 2:
Mailing Address - City:BARKHAMSTED
Mailing Address - State:CT
Mailing Address - Zip Code:06063-1816
Mailing Address - Country:US
Mailing Address - Phone:203-927-2268
Mailing Address - Fax:
Practice Address - Street 1:10 WARNER RD
Practice Address - Street 2:
Practice Address - City:BARKHAMSTED
Practice Address - State:CT
Practice Address - Zip Code:06063-1816
Practice Address - Country:US
Practice Address - Phone:203-927-2268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-08
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT025564164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse