Provider Demographics
NPI:1306903273
Name:GUTIERREZ, MARY LEILANI YOSHIKO (APRN)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:LEILANI YOSHIKO
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:500 ALA MOANA BLVD STE 1300
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-4912
Mailing Address - Country:US
Mailing Address - Phone:808-528-3657
Mailing Address - Fax:808-524-6552
Practice Address - Street 1:500 ALA MOANA BLVD STE 1300
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-4912
Practice Address - Country:US
Practice Address - Phone:808-528-3657
Practice Address - Fax:808-524-6552
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN433363LF0000X
MN4513363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily