Provider Demographics
NPI:1477171148
Name:GUEVARA, GABRIELA
Entity Type:Individual
Prefix:MRS
First Name:GABRIELA
Middle Name:
Last Name:GUEVARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19399 COUNTY ROAD 25
Mailing Address - Street 2:
Mailing Address - City:PLATTEVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80651
Mailing Address - Country:US
Mailing Address - Phone:970-534-8942
Mailing Address - Fax:
Practice Address - Street 1:19399 COUNTY ROAD 25
Practice Address - Street 2:
Practice Address - City:PLATTEVILLE
Practice Address - State:CO
Practice Address - Zip Code:80651
Practice Address - Country:US
Practice Address - Phone:970-534-8942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-09
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNO E