Provider Demographics
NPI:1255227344
Name:GUTIERREZ, KRISTIN LAUREN (FNP)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:LAUREN
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:LAUREN
Other - Last Name:STUMLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:229 N CANTERBURY RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-1445
Mailing Address - Country:US
Mailing Address - Phone:704-607-8800
Mailing Address - Fax:
Practice Address - Street 1:229 N CANTERBURY RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-1445
Practice Address - Country:US
Practice Address - Phone:704-607-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5021892363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner