Provider Demographics
NPI:1043746324
Name:GUTIERREZ, MARIA V (NNP)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:V
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1694 ZAMORA DR
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-1997
Mailing Address - Country:US
Mailing Address - Phone:956-266-1498
Mailing Address - Fax:
Practice Address - Street 1:1694 ZAMORA DR
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-1997
Practice Address - Country:US
Practice Address - Phone:956-266-1498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-05
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP108001363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal