Provider Demographics
NPI:1225581531
Name:GUTIERREZ, ELISA ALVA (FNP - C)
Entity Type:Individual
Prefix:MRS
First Name:ELISA
Middle Name:ALVA
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:FNP - C
Other - Prefix:MISS
Other - First Name:ELISA
Other - Middle Name:ANDREA
Other - Last Name:ALVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7215 MCPHERSON RD
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6554
Mailing Address - Country:US
Mailing Address - Phone:956-728-0323
Mailing Address - Fax:
Practice Address - Street 1:801 N US HIGHWAY 83
Practice Address - Street 2:
Practice Address - City:ZAPATA
Practice Address - State:TX
Practice Address - Zip Code:78076-3290
Practice Address - Country:US
Practice Address - Phone:956-765-8494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-03
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP130982363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily