Provider Demographics
NPI:1952601254
Name:GUTIERREZ, SHARON ANNE (PNP)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:ANNE
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:MRS
Other - First Name:SHARON
Other - Middle Name:ANNE
Other - Last Name:GUTIERREZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSN, RN, CPNP
Mailing Address - Street 1:5005 N PIEDRAS ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79920-5001
Mailing Address - Country:US
Mailing Address - Phone:915-742-1093
Mailing Address - Fax:
Practice Address - Street 1:BLDG. 11335 SSG SIMS ST.
Practice Address - Street 2:BIGGS AF
Practice Address - City:FT BLISS
Practice Address - State:TX
Practice Address - Zip Code:79918
Practice Address - Country:US
Practice Address - Phone:915-742-1093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-02
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX598845363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics