Provider Demographics
NPI:1477142925
Name:GUTIERREZ, PAOLA M (PA-S)
Entity Type:Individual
Prefix:
First Name:PAOLA
Middle Name:M
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:PA-S
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Other - Credentials:
Mailing Address - Street 1:62 SCHOOL ST APT 302
Mailing Address - Street 2:
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826-4664
Mailing Address - Country:US
Mailing Address - Phone:978-828-6523
Mailing Address - Fax:
Practice Address - Street 1:23 LOUISBERG ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-3428
Practice Address - Country:US
Practice Address - Phone:978-828-6523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-11
Last Update Date:2024-03-11
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical