Provider Demographics
NPI:1437622545
Name:GUTIERREZ, NIMSI PADUA (NP-C)
Entity Type:Individual
Prefix:
First Name:NIMSI
Middle Name:PADUA
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:NIMSI
Other - Middle Name:DAIZ
Other - Last Name:PADUA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1950 GLENN MITCHELL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-0168
Mailing Address - Country:US
Mailing Address - Phone:757-507-0600
Mailing Address - Fax:
Practice Address - Street 1:1950 GLENN MITCHELL DR STE 200
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-0168
Practice Address - Country:US
Practice Address - Phone:757-507-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-10
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024176255363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily