Provider Demographics
NPI:1295183358
Name:GUTIERREZ, ANGELA MARIE (FNP-C)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIE
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 SPICEWOOD SPRINGS RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8723
Mailing Address - Country:US
Mailing Address - Phone:737-226-6700
Mailing Address - Fax:
Practice Address - Street 1:3901 SPICEWOOD SPRINGS ROAD
Practice Address - Street 2:SUITE 201
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759
Practice Address - Country:US
Practice Address - Phone:737-226-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-31
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP130773363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily