Provider Demographics
NPI:1700391083
Name:GUTIERREZ, ANA MARIA (AGNP-BC)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:MARIA
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:AGNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:783 LEISTER DR
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-7440
Mailing Address - Country:US
Mailing Address - Phone:443-465-8948
Mailing Address - Fax:
Practice Address - Street 1:1946 GREENSPRING DR
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-4152
Practice Address - Country:US
Practice Address - Phone:410-560-7494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-07
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR184807363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health