Provider Demographics
NPI:1982937298
Name:GUTIERREZ, VIRGINIA RUTH (NP)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:RUTH
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 RESERVOIR ST
Mailing Address - Street 2:SUITE 25
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494-3149
Mailing Address - Country:US
Mailing Address - Phone:781-449-8900
Mailing Address - Fax:781-449-8911
Practice Address - Street 1:220 RESERVOIR ST
Practice Address - Street 2:SUITE 25
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494-3149
Practice Address - Country:US
Practice Address - Phone:781-449-8900
Practice Address - Fax:781-449-8911
Is Sole Proprietor?:No
Enumeration Date:2009-09-18
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MARN169789363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health