Provider Demographics
NPI:1093423600
Name:GUTIERREZ, ANGELICA LOUISE (APRN, CPNP-PC)
Entity Type:Individual
Prefix:MRS
First Name:ANGELICA
Middle Name:LOUISE
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:APRN, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10755 KENWORTHY ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79924-1717
Mailing Address - Country:US
Mailing Address - Phone:915-821-5900
Mailing Address - Fax:
Practice Address - Street 1:10755 KENWORTHY ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79924-1717
Practice Address - Country:US
Practice Address - Phone:915-821-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-11
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX788755163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics