Provider Demographics
NPI:1083816219
Name:GUTIERREZ, ELIZABETH ANNE (CNM)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANNE
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 947407
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30394-7407
Mailing Address - Country:US
Mailing Address - Phone:941-917-2600
Mailing Address - Fax:941-917-7884
Practice Address - Street 1:1700 S TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-3509
Practice Address - Country:US
Practice Address - Phone:941-917-8560
Practice Address - Fax:941-917-2675
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2024-02-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN9204187367A00000X
GARN179970367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife