Provider Demographics
NPI:1568007078
Name:GUTIERREZ, ANGEL PRISCILLA (LVN)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:PRISCILLA
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 CASTLEWOOD DR APT 1F
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-8140
Mailing Address - Country:US
Mailing Address - Phone:830-302-1417
Mailing Address - Fax:
Practice Address - Street 1:301 CASTLEWOOD DR APT 1F
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-8140
Practice Address - Country:US
Practice Address - Phone:830-302-1417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-08
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX350924164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse