Provider Demographics
NPI:1497001028
Name:GUTIERREZ, MARIA ISABEL (STNA)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ISABEL
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1929 JOSEPH ST
Mailing Address - Street 2:
Mailing Address - City:NORTHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:43619-1209
Mailing Address - Country:US
Mailing Address - Phone:567-686-9027
Mailing Address - Fax:
Practice Address - Street 1:1929 JOSEPH ST
Practice Address - Street 2:
Practice Address - City:NORTHWOOD
Practice Address - State:OH
Practice Address - Zip Code:43619-1209
Practice Address - Country:US
Practice Address - Phone:567-686-9027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-01
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400283080903374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide