Provider Demographics
NPI:1275200826
Name:GUTIERREZ, HOPE DENISE (PA-C)
Entity Type:Individual
Prefix:
First Name:HOPE
Middle Name:DENISE
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:HOPE
Other - Middle Name:DENISE
Other - Last Name:SALZMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:819 N BIRCH AVE
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-2517
Mailing Address - Country:US
Mailing Address - Phone:580-504-4231
Mailing Address - Fax:
Practice Address - Street 1:6161 S YALE AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-1992
Practice Address - Country:US
Practice Address - Phone:918-494-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5155363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant