Provider Demographics
NPI:1194207423
Name:GUTIERREZ, ARIANA M (RN)
Entity Type:Individual
Prefix:
First Name:ARIANA
Middle Name:M
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12000 DESSAU RD APT 1124
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78754-2101
Mailing Address - Country:US
Mailing Address - Phone:310-367-0385
Mailing Address - Fax:
Practice Address - Street 1:12000 DESSAU RD APT 1124
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78754-2101
Practice Address - Country:US
Practice Address - Phone:310-367-0385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX930892163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse