Provider Demographics
NPI:1740845312
Name:GUTIERREZ, ANA B (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:B
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 THORNWOOD ST
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78574-2378
Mailing Address - Country:US
Mailing Address - Phone:956-570-9887
Mailing Address - Fax:
Practice Address - Street 1:703 THORNWOOD ST
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78574-2378
Practice Address - Country:US
Practice Address - Phone:956-570-9887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-08
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX547501163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000OtherNONE