Provider Demographics
NPI:1902308588
Name:GUTIERREZ, SANTA C (FNP-C)
Entity type:Individual
Prefix:
First Name:SANTA
Middle Name:C
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8318 JONES MALTSBERGER RD STE 121
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-6552
Mailing Address - Country:US
Mailing Address - Phone:210-348-7529
Mailing Address - Fax:
Practice Address - Street 1:1603 BABCOCK RD STE 234
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4741
Practice Address - Country:US
Practice Address - Phone:210-998-1810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-28
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX832581163W00000X
TX1017587363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse