Provider Demographics
NPI:1881936912
Name:GUTIERREZ, EMILY (DNP, CPNP, IFM-CP)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:DNP, CPNP, IFM-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6618 SITIO DEL RIO BLVD STE D102
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78730-1148
Mailing Address - Country:US
Mailing Address - Phone:512-599-8850
Mailing Address - Fax:512-599-8777
Practice Address - Street 1:6618 SITIO DEL RIO BLVD STE D102
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78730-1148
Practice Address - Country:US
Practice Address - Phone:512-599-8850
Practice Address - Fax:512-599-8777
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-27
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX674920163WP0200X
TX6749201363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics